Full text of The Problem of Dust Phthisis in the Granite-Stone Industry : Bulletin of the United States Bureau of Labor Statistics, No. 293

The full text on this page is automatically extracted from the file linked above and may contain errors and inconsistencies.

U. S. DEPARTMENT OF LABOR
JAMES J. DAVIS, Secretary

BUREAU OF LABOR STATISTICS
ETHELBERT STEWART, Commissioner

BULLETIN OF THE UNITED STATES \
BUREAU OF LAB O R S T A T IS T IC S /
INDUSTRIAL

ACCIDENTS

AND

•■■■
HYGIENE

{No. 293
SERIES

THE PROBLEM OF DUST PHTHISIS
IN THE GRANITE-STONE INDUSTRY




By FREDERICK L. HOFFMAN, LL.D.

/ v \ *1
U
sj
yg f e g f
p H

M A Y , 1922

WASHINGTON
GOVERNMENT PRINTING OFFICE
1922




PREFACE.

In continuation of previous investigations into the dust hazard of
certain trades/ the present investigation was originally undertaken
in behalf of a committee appointed by the National Tuberculosis
Association, and while the writer was chairman two preliminary
reports were published during 1918 and 1919. It was found imprac­
ticable* however, on the part of the writer to continue his work as
chairman of the committee and the investigation was therefore
brought to a conclusion entirely on his own responsibility, the strictly
medical and radiological work of the inquiry having been assumed
by Dr- Edward R. Baldwin, whose report, dated June 11, 1921, is
published in Appendix G. This report did not come to my attention
until after my own investigations had been completed and on account
of its brevity much of the material required for a conclusive opinion
is for the time being not available.2
It is to be hoped that sometime in the future the National Tubercu­
losis Association will publish in full detail the results of this investi­
gation, which represents 427 physical and X-ray examinations of
stone workers in the Barre district. Of particular interest is the
statement that “ expensive silicosis might exist with little or no
impairment of health and no manifest physical signs,” a conclusion
suggestive of the great practical value of periodical X-ray examina­
tions as a means of disclosing the earliest possible indications of
lung damage.
My own investigations would have been quite impossible but for
the whole-hearted cooperation of the Granite Cutters’ International
Association of America and the correlated experience data obtained
b u lletin s Nos. 79, 82, and 231 of the U. S. Bureau of Labor Statistics, Washington, D. C., 1908-1918.
2 Since this report was completed the Barre branch of the Granite Cutters’ International Association
has made an agreement with the Presbrey-Leland Co. of Barre, V t., to go into effect Apr. 1,1922, and con­
tinue in force until Apr. 1, 1925.
Article V I of this agreement provides as follows:
S e c t io n 1. All dust-creating machines must be adequately equipped with dust-removing devices when
proven practical, the practicability of such devices to be passed upon in accordance with provisions laid
down in Article X X of this agreement [providing for an adjustment committee].
Sec. 2. Within one month from the signing of this agreement a body of six members, to be known as
the ‘‘ health committee/’ shall be created. Of the committee three members shall be appointed by the
employer and three by the local branch G. C. I. A. It shall be the duty of this committee to investigate,
to assist in the development, the perfecting, and the introduction of dust-removing devices; to consider
insurance against sickness and improve in every possible way general working conditions.
Sec. 3. Funds for the development and experimental work of this committee shall be provided in the
following manner: One-hal i o 11 per cent to be deducted weekly from the wage of each member of the local
branch G. C. I. A. The employer to set aside each week an amount equal to the total sum derived from
the above source. This fund shall be placed in the hands ofa treasurer elected by a majority of the health
committee. Should the funds thus provided be either inadequate or more than sufficient for the desired
purpose, any necessary modification may be made by mutual agreement.
S e c . 4. The health committee shall make a written progress and financial report on or about Apr. 1
and Oct. 1 of each year to the employer and thel ocal branch G. C. I. A.
Sec. 5. Should the members of the health committee be unable to agree, any subject in controversy
shall be submitted to the adjustment committee in accordance with Article X X of this agreement.
This provision is in entire accordance with the results of the present investigation suggesting similar
action on the part of other firms or employers desirous of avoiding labor conflicts as the results of prevent­
able conditions affecting the health hazard in particular industries or occupations. The agreement is
likewise applicable to other dusty trades subject to an excessive sickness or mortality rate.




Ill

IV

PREFACE.

through the courtesy and liberality of the Journeymen Stone Cutters’
Association and the Glass Bottle Blowers’ Association. The field
investigations were made by an experienced sanitary engineer,
thoroughly familiar with occupational disease problems, and I am
also obliged to Mr. Sylvester Schattschneider for the results of his
corresponding investigations in the limestone districts of Indiana.
Every possible opportunity for investigation was extended to me by
the manufacturers of the Barre and Bedford districts, who readily
granted permission for a complete inspection of their plants, at the
same time giving much valuable advice in the furtherance of the
inquiry. I am especially indebted to the United States Bureau of
Mines, and particularly to Mr. E. A. Holbrook, assistant director,
and to Mr. A. C. Fieldner, supervising chemist at the Pittsburgh
Experimental Station, for their invaluable cooperation in technical
matters largely outside of the plan and scope of my own investiga­
tions. Preliminary results of the work of the Bureau of Mines are
included under Appendix E. It is not claimed for the present in­
vestigation that it has been exhaustive or final upon many important
matters, which will require further consideration. But it may be
questioned whether any corresponding industry has ever before been
subjected to an equally extended inquiry, not only into the medical
but also into the correlated social and economic facts affecting the
welfare of the employees concerned. The results are certainly
extremely suggestive 01 the direction in which it will be necessary to
initiate radical reforms if a material reduction in mortality and a
consequential improvement in health and longevity are to be brought
about through the combined action of the employer, the employee,
and the State.
F rederick L. H offman.
E ast Orange , N. J., A p ril 17, 1922.




CONTENTS.
Page.

Introduction and summary............................................................................................. 1-10
1-6
Summary of conclusions..........................................................................................
Nonrecognition of the nature of problem.............................................................
6 -8
Results of investigation of Miners’ Phthisis Bureau of South Africa.............
8
Recommendations of British Medical Research Committee............................
8
Investigations of Yale Medical School.................................................................
8, 9
Investigations of United States Public Health Service....................................
9
Unrealized promises of prevention........................................................................ 9, 1 0
Importance of occupational disease recognition.................................................
10
Scope of inquiry................................................................................................................ 10-14
Method of inquiry..................................................................................................... 11,12
Occupational diseases of the stone industry........................................................
12
Importance of occupational segregation............................................................... 12,13
Pathology of dust inhalation................................................................................... 13,14
Previous investigations in the stone industry............................................................. 14-22
Ancient origin of the stone industry..................................................................... 14,15
Aberdeen mortality investigations........................................................................ 15-22
Age incidence in dust phthisis....................................................................... 18,19
Effect of pneumatic tools................................................................................. 19-21
21
Racial and social influences............................................................................
21
Problem of family infection___ . ............................................ .. ....................
Importance of stone dust analysis................................................................. 21, 22
Mortality among granite stone workers......................................................................... 22-59
Analyses of Vermont granites................................................................................. 22, 23
24
Sanitary topography of Barre district, Vermont...............................................
Death certificates analyzed....................................................................... ............ 24, 25
Mortality experience of the Granite Cutters’ International Association___ 25-27
Comparative New England mortality data.......................................................... 27-29
Value of proportionate mortality figures.............................................................. 29-31
Occupational mortality in the granite industry................................................. 31, 32
Mortality from all causes.......................................................................................... 33, 34
Mortality by single years of life............................................................................. 35, 36
Tuberculous and nontuberculous lung diseases......................................... ....... 36, 37
Comparative occupational mortality......................................................... . T___ 37-39
Effect of the stone industry on influenza mortality.......................................... 39-42
Effect of trade life on mortality........ . . . . ............................................................ 42-45
Occupational distribution in the granite industry............................................. 45,46
Physique of granite workers.................................................................................... 46-49
Physique in relation to race.................................................................................... 49-51
Sanitary conditions................................................................................................... 52-55
Absence of overcrowding......................................................................................... 55-58
Absence of family infection..................................................................................... 58, 59
Mortality among families of granite cutters................................................................. 59-68
Family mortality records of granite cutters......................................................... 59-61
Family mortality records of farmers.................................................... . . ............. 62, 63
Evidence conclusive as to an excessive mortality from dust phthisis..........
64
Evidence inconclusive as to contact infection.................................................. 64-68
Trade life and occupational changes....................................................... ..................... 69-81
Occupation the primary causative factor of excessive tuberculosis mortality. 69, 70
Absence of previous occupational predisposition............................................... 70-77
Comparative mortality of limestone workers...................................................... 77-81
Supplementary considerations............... .........................................................................82-89
Average age at death................................................................................................ 82-85
Mortality of granite manufacturers........................................................................85, 8 6
Differences in stone composition........................................................................... 8 6 , 87
Regularity of employment.......................................................................................87-89




v

VI

CONTENTS.

Comparative occupational mortality data................................................................. 89-107
Mortality of limestone and sandstone cutters and glass-bottle blowers......... 89-96
Swiss occupational experience............................................................................... 97-99
Dutch occupational experience.......................................................................... 100-101
English occupational mortality statistics......................................................... 103-107
Stone-dust correlation data........................................................................................ 108-112
Graphic presentation of results of investigation............................................. ..
113-119
Other investigations............................................................ ..................................
120-130
German occupational experience...................................................................... 120,121
Recent Bendigo (Australia) investigation........................................................ 121-123
American industrial dust investigations........................................................... 123,124
Suggestive medical observations....................................................................... 124-127
The problem of lung fibrosis....................................................................... 124,125
Diagnostic difficulties.......................................................................................
126
The problem of dust infection............. ^...................................................... 126,127
Investigation of Miners’ Phthisis Commission of South Africa................... 127-130
Miner’s phthisis, or silicosis.............................................................................
127
Conclusions of previous investigations......................................................127,128
Pathology of lung fibrosis............................................................................ 128,129
Differentiation of disease symptoms.............................................................
129
Silicosis and tuberculosis............................................................................. 129,130
General conclusions . . . : .............................................................................................. 130-137
Contradictory medical opinions........................................................................ 130,131
Results of South African medical research...................................................... 131,132
South African silicosis statistics.....................................................................
132
British silicosis act............................................................................................... 132,133
Recent silicosis investigations............................................................................. 133,137
Physical signs of silicosis..................................................................................
135
Descriptive cases........................................................................................... 1 3 5, 136
Primary importance of silicosis......................................................................
136
Danger of erroneous conclusions................................................................. 136,137
Restatement of silicosis conclusions..............................................................
137
Appendix A.— Inquiry blank used in this investigation.....................................138,139
Appendix B.—Medical blank recommended............ .................... ...................... 139,140
Appendix C.— Incidence of pulmonary tuberculosis in trades with exposure to
mineral dust............................................................................................................... 340-143
Appendix D.— Mineralogy of the dust problem.........................................................
144
Appendix E .—Analysis of granite stone dust. (Barre, Vt., and Aberdeen,
Scotland)..................................................................................................................... 145-149
Appendix F.— Stone workers’ mortality, Aberdeen, Scotland........................... 149-152
Appendix G.— Report of medical investigation of granite cutters of Barre, V t. 153-161
Appendix H.— German sick-fund experience..........................................................
162
Appendix I.— List of references............................................................................... 163-167
CHAETS.
Chart 1 .— Comparative proportionate distribution of granite cutters of Barre,
Vt., limestone cutters of Bedford, Ind., and Transvaal gold
miners, by years of employment......................*......................................
Chart 2 .—Mortality from specified causes among granite cutters of New England
compared with that of the adult males of Massachusetts, by periods
of years...........................................................................................................
Chart 3.—Mortality of granite cutters of Barre, Vt., and adult males of Mas­
sachusetts,. 1911-1917, by divisional periods of life..........................
Chart 4.— Mortality from tuberculosis of the lungs among granite cutters, by
geographical districts and periods of years............................................
Chart 5.—Correlation between the chemical composition of stone and mortality
from tuberculosis of the lungs among granite cutters, sandstone
cutters, and limestone cutters, by periods of years..........................
d iart 6 .— Family mortality from tuberculosis of the lungs of granite cutters com­
pared with that of farmers, of Washington and Caledonia Counties,
Vt., 1893-1919..............................................................................................




114
115
116
117
118
119

BULLETIN OF THE

U. S. BUREAU OF LABOR STATISTICS.
NO. 293

WASHINGTON

M A Y , 1922

H E PROBLEM OF DUST PHTHISIS IN THE GRANITESTONE INDUSTRY.
INTRODUCTION AND SUMMARYIn continuation, of investigations into the mortality from tubercu­
losis in dusty trades, extending over a long period of years, the present
inquiry into the mortality of granite-stone workers in the State of
Vermont was decided upon after careful consideration as both an
insurance and a medical problem of the first importance. In the
rating practice of insurance companies stone cutting is generally
classed as a single industry, although it has long since been recog­
nized that material variations are met with in the different branches
as regards the nature of the dust inhaled. The preliminary con­
sideration of the present investigation is set forth in Mortality from
Respiratory Diseases in Dusty Trades (Inorganic Dusts), published
by the United States Bureau of Labor Statistics in June, 1918, as
Bulletin No. 231 and the first and second preliminary reports of the
committee on mortality from tuberculosis in dusty trades, of the
National Tuberculosis Association, published in 1919. For the pres­
ent purpose the results here presented are largely limited to the
statistical aspects of the problem, though equally urgent is a com­
prehensive descriptive account of shop conditions and processes of
manufacture bearing directly upon health hazards.
SUMMARY OF CONCLUSIONS.

The results, in a general way, may be summarized as follows:
(1) The granite-stone industry is carried on by wage earners who,
broadly speaking, live under sanitary conditions above the average,
so that possibly unfavorable environmental factors are of decidedly
secondary importance.
(2) The housing conditions under which granite workers live are
also above the average, so that in this respect the environmental
factors are favorable to a low mortality rather than otherwise.
(3) Anthropometric records clearly establish the fact of & superior
physique, indicative of a higher degree of disease resistance, as deter­
mined by a relative weight above the average. From this point of
view, therefore, granite workers should experience a relatively low
mortality from pulmonary tuberculosis instead of a mortality decid­
edly above the average normal to industrial occupations.




1

2

DUST PH TH ISIS IK THE GRANITE-STONE INDUSTRY.

(4) Granite workers, considered by specific occupations, show wide
variations in tuberculosis frequency, the excess in the death rate
being most marked among the men employed in granite-stone cut­
ting, it being especially severe among the men employed in the use
of pneumatic tools. Certain occupations, such as polishing, tool
sharpening, bed setting, etc., do not show a marked excess, if any,
in the mortality from pulmonary tuberculosis, clearly indicating that
the risk is practically proportionate to dust exposure.
(5) Compared with the normal death rate of adult males of the
State of Vermont, or of New England, the mortality from pulmonary
tuberculosis among granite-stone workers has increased enormously
during the last two years, as contrasted with a diminishing mortality
in the population at large. Against a decrease in the pulmonary tu­
berculosis death rate of adult males of the State of Massachusetts
from 288.5 per 100,000 exposed to risk during 1895-1899 to 203.2
during 1915-1918 there had been an increase in the corresponding
death rate of granite cutters of the New England States from 432.0
per 100,000 during 1895-1899 to 1056.7 during 1915-1918.1 The
only other occupation for which information is available for the cor­
responding period of time is that of glass-bottle blowers, among whom
the mortality from pulmonary tuberculosis diminished from 418.6 per
100,000 to 265.9. These statistics for the New England States are
confirmed by similar data for every other stonecutting center of the
United States, proving with absolute certainty that in every section
of the country the tuberculosis mortality of this group of industrial
workers is increasing, in contrast to a locally diminishing death rate
from this most fatal of all diseases.
The same conclusion applies to nontuberculous respiratory dis­
eases, for it is shown that the mortality from bronchitis, pneumonia,
and asthma is also on the increase among granite cutters, in contrast
to a diminishing rate of frequency among adult males of the general
population.
While normally the rate of tuberculosis frequency diminishes with
increasing adult age, the contrary is shown to be the fact as to granite
cutters, among whom the death rate from pulmonary tuberculosis
at ages 60 and over reaches truly appalling proportions, so much so
that the statistical evidence would seem incredible if it were not
supported by the additional and equally suggestive data for non­
tuberculous respiratory diseases.
(6) The investigation brings out clearly the supremely important
fact that the incidence of the disease is practically proportionate to
the length of the trade life. In other words, the effect of dust inhala­
tion is one of growing seriousness, according to the rate of dust accu­
mulation in the lungs. It is shown that normally a maximum effect
is produced by the twenty-first year of trade life, and that therefore
stone centers with a comparatively new or largely shifting popula­
tion will fail to disclose the seriousness of the situation, which is
readily observed in the stone centers with a fixed and long-settled
population.
These conclusions are in conformity to the observations made in
South Africa and Australia, clearly indicating that the cause of the
excessive liability to pulmonary tuberculosis is the inhalation of
1 Exclusive of last three months of 1918.




INTRODUCTION AND SUMMARY.

3

granite dust in a comminuted form of practically ultramicroscopical
particles.
(7) Unfortunately, no autopsy material is as yet available in
this country to determine the dust content of the silicotic lung.
In no direction can modern experimental medicine render more
useful assistance than in this. The commendable work of the South
African Institute for Medical Research may be referred to as an
example which should be followed in this country.
(8) The nature of the dust inhaled also requires much more ex­
tended scientific consideration. For the present purpose, however,
it is sufficient to state that the average silicotic content of granite is
72.96 per cent; of sandstone, 85.42 per cent; and of limestone, 1.22
per cent.
The evidence is absolutely conclusive that the dust hazard depends
primarily upon the silicotic content of the dust inhaled. The evi­
dence is also conclusive that workers exposed to marble or limestone
dust suffer a decidedly lesser liability to pulmonary tuberculosis than
those exposed to granite or sandstone dust, with a high silicotic content.
It is regrettable that for the time being no trustworthy data as to
the death rate of marble workers from pulmonary tuberculosis should
be available, but it may be said from such investigations as
have been made that as to mortality from this cause, the marble
industry of the State of Vermont is in marked contrast to the granite
industry carried on under much the same conditions except for the
nature of the dust. But original material has been collected for the
limestone industry, as represented in southern Indiana, on the basis
of which it is possible to state that for the period 1915-1918, in con­
trast to a death rate from pulmonary tuberculosis of 1,044.3 per
100,000 exposed to risk for granite cutters and 1,029.9 for sandstone
cutters, the mortality of limestone cutters was only 425.5 and of
glass-bottle blowers, also exposed more or less to a dust hazard,
265.9 per 100,000. Recalling that the normal pulmonary tuber­
culosis mortality of adult males in Massachusetts is only 203.2 per
100,000, it is shown that the present death rate from pulmonary
tuberculosis among granite cutters is five times the normal expe­
rience in the population at large, and probably six times what it should
be on the basis of strictljr noninjurious occupations carried on
largely under hygienic conditions and in the open air.
The dust problem, in its mechanical as well as pathogenic aspects,
and in its particular application to the granite-stone industry, has
never received the requisite technical consideration, the urgency of
which is clearly indicated by the preceding conclusions. It is
encouraging, however, to be able to say that as a result of the present
investigation the United States Bureau of Mines has initiated a
study of the dust problem, the findings of which will be forthcoming
in due course of time and will no doubt throw much valuable light
upon aspects now more or less obscure.
Nor has the subject received the requisite consideration from the
medical point of view, for there are abundant reasons for believing
that the disease certified as pulmonary tuberculosis among granite
workers is often not a true form of tuberculosis, but, strictly speaking,
a silicosis or pneumonoconiosis, or, in other words, dust phthisis of
nontubercular origin, though possibly in its terminal stage compli­
cated by a superinduced tuberculosis. If this conclusion is correct,




4

BUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

the medical profession has been derelict in not recognizing important
differences in the symptomatology of the disease, which, as judged
by the available evidence, must present material variations from the
normal course of the disease as manifest in those who suffer from
pulmonary tuberculosis not complicated by dust phthisis.
To much the same effect is the further conclusion that methods of
prevention applicable to a true form of tuberculosis will be largely
inapplicable to a disease chiefly nontubercular in its origin and
frequently nontubercular in its termination. In other words, the
so-called campaign against tuberculosis rests upon the theory of the
disease being infectious, and therefore transmissible froln one person
to another. If, however, the disease as it occurs with such excessive
frequency among granite-stone cutters is largely nontubercular or
nonbacillary in its origin and progress, it is self-evident that it can
not be infectious, and does not, therefore, constitute a serious menace
to the adult population.
If the disease is nontuberculous, it must also be self-evident that a
different form of treatment may be required in many cases and that
the treatment usually followed in pulmonary tuberculosis may prove
of no value. The South African investigations, briefly referred to,
clearly indicate that differences in treatment are called for on a
better understanding of the true nature of the ailment when affecting
men employed in the granite-stone industry. If these conclusions
should be sustained by subsequent investigations, it is clear that no
progress toward a material reduction in the death rate is likely to be
made until the present apathy on the part of the medical profession
gives way to a clearer realization of the problems and difficulties
that are involved in the present case.
(9) One important aid in diagnosis often overlooked is the practical
usefulness of radiological examinations of the chest. It is hoped that
the emphasis given to the urgency of such investigations may yield
satisfactory results in the future. For the present purpose it may
be sufficient to say that radiological examinations have been of the
utmost value in determining the progress of dust infiltration through­
out the lungs and in clearly indicating the extent of stone consoli­
dation to the point of fatality.
If the so-called pulmonary tuberculosis among granite-stone
cutters is not a true tuberculosis and therefore not infectious, some
evidence should be forthcoming from the family records of deceased
stone workers to substantiate this point of view. As a matter of fact,
the results of the present investigation emphatically support this con­
clusion and prove that relatives dying from tuberculosis, either
prior or subsequent to the deaths of granite cutters dying from
tuberculosis, have been relatively few among the wives and daughters,
while relatively very common among fathers, sons, and brothers,
much less exposed to personal contact, but in all probability also
employed in the granite-stone industry.
(10) The present investigation includes the question of previous
occupation and many related aspects which do not admit of a brief
generalization. It may be said, however, that there is nothing to in­
dicate otherwise than that the men, industrially considered, are of &
superior social and economic status, which should be more than a nor­
mal safeguard against an excessive liability to dust phthisis, The
wages in the granite industry are relatively high, and the hours of




INTRODUCTION AND SUMMARY.

5

work are below rather than above the normal, but at the same timej
it should be pointed out, in the northern section of the country during
the winter months, indoor employment being the rule, the dust hazard
is enormously increased in severity. While much has been done with
regard to dust reduction, there are reasons for believing that the most
dangerous form of dust is not successfully removed, if at all, by the
devices generally in use. Shop conditions vary widely, but give evi­
dence of superficial industrial inspection on the part of the State and a
lack of appreciation of the menace of the dust as a health-injurious
element of the industry. A further fact which bears directly upon the
question is the comparative rarity of vacations of sufficient length,
which, habitually followed, would unquestionably increase disease re­
sistance. The question, in fact, may well be raised whether it would
not be compatible with the best interests of all concerned to prohibit
indoor stone cutting by pneumatic tools entirely unless an effective
dust removing device can be introduced which will do away with the
dust hazard now common to practically all the shops in which indoor
work during the winter is a necessity. In the southern States, where
most of the work is done out of doors, the death rate from pulmonary
tuberculosis among granite cutters during the period 1912-1918 was
only 441.1 per 100,000 of population, against 962.3 for the New Eng­
land States. This difference may safely be attributed in a large
measure to the fact that indoor employments are much less common
in the South than in the North.
(11)
In the aggregate, the evidence clearly supports the conclusion
that the granite-stone industry, perhaps more than any other dusty
trade, demands the utmost, and thoroughly qualified, consideration
on the part of the State, the medical profession, and the labor organi­
zations directly concerned. At the present time the death rate among
granite workers is practically the highest known for any occupation
of record, and the increase in the death rate from year to year is la­
mentable evidence of inefficiency on the part of health-promoting
agencies to bring about reduction and control. The problem concerns
not only the wage earners, who directly pay a frightful toll in needless
deaths and prolonged chronic disease, but the burden also falls, and
possibly with crushing weight, upon the industry, which is deprived
of skilled workers, indispensable to the trade, and of apprentices, no
longer attracted to an occupation recognized even among those not
familiar with the statistical facts as one of the most deadly on record.
The present inquiry should prove of particular value as an indica­
tion of new methods by which the facts of industrial health can be
determined with practical certainty and at minimum expense.
The investigation emphasizes the futility of broad generalizations,
in which essential matters of detail are disregarded. There is a
vast amount of superficial observation and advice on the dust prob­
lem in industry which serves no practical purpose whatever. There
are unquestionably important conclusions, even some which have
been given utterance by high authority, which are no longer in exact
conformity to the facts. The general prevailing theory on the
subject has been well stated by Prof. Edgar L. Collis in a recent
work on The Industrial Clinic (p. 80), as follows: ‘ 1Long-continued
inhalation of dust favors diseases of the lungs, especially bronchitis
and emphysema, interstitial pneumonia, and fibroid phthisis, the
disease varying with the nature of the dust. The character of the




6

DUST PH TH ISIS 11ST THE GRANITE-STONE INDUSTRY.

particles composing dust is of special importance. The most injurious
kinds are insoluble and inorganic dusts, which become impacted
in the walls of the bronchioles or air cells of the lungs, are not easily
expectorated, and set up irritation and chronic inflammation of the
tissues around. The soluble and organic particles are much less
injurious. For example, the relative innocuity of coal dust in
causing lung disease is marked in comparison with the lung mischief
revalent amongst cutlers, file makers, needle, pin, and tool makers.”
et even these simple facts are far from being recognized as regards
their true etiological significance in the tuberculosis policy of State
industry.

?

NONRECOGNITION OF THE NATURE OF PROBLEM.

In a program report of a committee on tuberculosis policy, pre­
sented to the Conference of State and Provincial Boards of Health
at Atlantic City, N. J., on June 6, 1919, there is not a single reference
to the dust problem in 16 specific recommendations bearing chiefly
upon treatment and public control after a reportable stage of the
disease has been reached. In this program, as in so many other
notable efforts the sanatorium treatment of the disease is over­
emphasized as a public question, when prior consideration should be
given to preventive measures giving promise of practical results.
The policy of the State should be not to begin with the first recogni­
tion of developed disease in the patient, but to recognize pretuberculous possibilities or predisposing conditions, the effective control
of which alone can justify the hope of far-reaching results. Refer­
ence may here be made to an interesting recognition of the foregoing
point of view in a discussion on “ How tuberculosis schemes fail, and
why,” by Dr. Stephen J. Maher, of New Haven, Conn., in the Medical
Record of December 11, 1920. This author summarizes his views
as follows:
(a) The overemphasis given to the value of the activities of the nonmedical anti­
tuberculosis workers.
( b) The disinclination of most physicians to join heartily in a medical campaign
dominated by nonmedical functionaries.
(c) The disinclination or inability of these nonmedical officials to indorse dr utilize
medical research.
(d) The obtuseness of even the medical officers of the tuberculosis campaigns to
the importance of the following facts:
( 1 ) Aside from its specific toxic power, the most important character of the tubercle
bacillus is its waxy, resistant capsule.
( 2 ) Serological tests prove that there is a family relationship between the tubercle
bacilli and all bacilli that possess these waxy capsules.
(3) Many ordinary nonacid-fast bacteria, when subjected to an unfavorable envi­
ronment, develop waxy capsules,and thus become demonstrably family relations of
the tubercle bacillus.

Much more than all this is involved in the failure of the so-called
campaign against tuberculosis to develop a thoroughly effective plan
giving the assurance of measurable results within a reasonable period
of time. Until the industrial aspects of the disease, and particularly
the dust question, are more clearly realized, there is little hope of a
reduction of tuberculosis frequency among industrial workers, whose
economic value to the nation entitles them to first consideration.
One recent writer, whose work is widely used as a text-book, has
riven utterance to the belief that “ the higher incidence of tubercuosis among those exposed to inorganic dust is due to the fact that

f




INTRODUCTION AND SUMMARY.

7

dust acts as a convenient carrier of tubercle baccilli. In other words,
it is not the preliminary injury which the dust is responsible for that
predisposes the individual to tuberculosis, but the readiness with
which tubercle bacilli may be carried into the respiratory tract by a
dust-laden atmosphere.” As said in an editorial in the Lancet of
November 15, 1919 (p. 888): “ This theory does not account * * *
for the tuberculous death rate of granite dressers, who are greatly
exposed to dust, working, as many of them do, in closed sheds and
using pneumatic tools, being lower than that of sandstone masons,
who, working with hammer and chisels in open lean-to-sheds, are
less exposed to dust; but sandstone is nearly pure silica, while granite
only contains 30 per cent. [In the United States this is 73 per cent.]
Tuberculosis implanted on silicosis has clinical manifestations and an
underlying pathology which clearly distinguishes it from tubercu­
losis (possibly dust-borne in origin) not associated with silicotic
fibrosis.” Both the author and the critic fall lamentably short of
the requisite thoroughness in discussions of this kind. If the present
investigation proves anything of value, it clearly indicates that the
so-called pulmonary tuberculosis in the granite-cutting industry is
not a true form of tuberculosis in the large majority of cases, but in
its origin and development a true silicosis, wThich may or may not
be complicated by superinduced bacillary infection. To allege that
such a disease is contracted by infected dust particles is to display
complete ignorance of the true mechanical and pathological questions
involved. It is equally erroneous to assume that granite dust con­
tains only 30 per cent of silica, for there is not & granite dust in this
country of which samples have been available for the present pur­
pose which does not contain from 70 per cent to 90 per cent of this
most injurious element. Unfortunately, dust samples of the Aber­
deen quarries which had been expected had not been received in
time for consideration in this report.2
In continuation of the foregoing extract from the Lancet it is said:
“ We are surprised to find a clinician of Dr. Landis’s standing not
accentuating more clearly these two clinical types of pulmonary
tuberculosis, especially when referring to the occurrence of phthisis
among textile operatives, tobacco-factory workers, and garment
makers.” In the case referred to pulmonary tuberculosis from the
type of dust involved is primarily a nontuberculous interstitial
pneumonia, or a true silicosis, without bacillary infection, essentially
different both as to diagnosis and prognosis from pulmonary tuber­
culosis in the accepted form. According to the Lancet it is regret­
table that the statement should have been made that “ the sharper
and more angular the dust particles the greater will be the amount of
mechanical injury, and hence the greater the inflammatory reaction.”
“ Assuredly,” it is said, “ minute particles, mostly below 1 micron
in diameter, moving slowly in the moist interior of an alveolus, can
have no power to cause mechanical injury; were the matter in doubt
the comparative absence of fibrosis in those exposed to the inhalation
of fine emery and glass dusts, hard, angular, and spicular as they are,
would lay it at rest. Silica dust is dangerous, not on account of its
hardness and shape, but of its chemical composition.” Much of this,
2 Since this was written a preliminary report on Aberdeen granite dust samples, furnished by Dr.
Matthew Hay, has been made by the United States Bureau of Mines (see pp. 147-149).




8

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.

it may be respectfully submitted, borders on blind conjecture. The
cause of industrial disease prevention is not advanced by guesswork
theorizing, even though the authors are otherwise recognized authori­
ties in their profession.
RESULTS OF INVESTIGATION OF MINERS’ PHTHISIS BUREAU OF SOUTH
AFRICA.

It may not be out of place to quote in this connection from an
article in the British Medical Journal of January 1, 1921, reviewing
the annual report of the Miners’ Phthisis Medical Bureau of South
Africa for 1919, based upon 32,000 statutory clinical examinations
and investigations, the following statement:
The prevalence of pulmonary tuberculosis, whether “ pure” or complicated by sili­
cosis, as revealed at the periodical examinations of 15,000 miners of European descent,
was at the rate of 1,141 per 100,000, as compared with 1,267 and 909 for the two pre­
ceding years, respectively. The prevalence rate of silicosis, whether in its pure form
or complicated by tuberculosis, was 5,532 per 100,000, as compared with 5,602 and
5,595 for the two previous years. As ascertained at the periodical examinations, the
attack rate of tuberculosis not complicated by silicosis was 255 per 100,000, as com­
pared with 259 for the preceding year.
RECOMMENDATIONS OF BRITISH MEDICAL RESEARCH COMMITTEE.

These observations suggest the urgent need of a much more quali­
fied study of the subject than has thus far been made. The interest
at stake is the health and well-being of an important section of our
industrial population, which has a right to insist that phrases and
platitudes give way to facts and trustworthy conclusions. A brief
reference may therefore be made to what is probably the most prom­
ising line of research being carried on at the present time. The
Medical Research Committee of the Privy Council of Great Britain
during the last two years has published two volumes on The Science
of Ventilation and Open-Air Treatment, which are indicative of
strictly scientific methods and which may safely be relied upon as
ultimately rendering assistance in the furtherance of the objective
indicated. The second volume includes a discussion of the dust
problem, in which, among other matters, mention is made of the
work of Winslow and Browne and the important statistical conclusion$ of Brownlee. There is also included a table, compiled by
Collis, with reference to Aberdeen granite cutters, showing “ the far
greater incidence of deaths from respiratory diseases in shut-up
granite-cutters’ shops than in open-air sections of the works.7’ While
the conclusions advanced are for the time tentative, the methods of
the medical research committee are suggestive of the direction to be
followed to advantage in similar investigations in this country. The
foregoing suggests also a brief reference to a publication on Ventilation
of Factories and Workshops, issued by the Home Office, London,
1920, containing a brief outline of standards of ventilation, localized
air circulation and ventilation tests, useful in the practical considera­
tion of the problem as met with in the granite industry in this country.
INVESTIGATIONS OF YALE MEDICAL SCHOOL.

In conclusion, attention may properly be directed to investigations
in this country which will bear favorable comparison to what is being
done abroad. Foremost among those who are to-day actively




INTRODUCTION AND SUMMARY*

9

prosecuting technical studies of the dust problem are Prof. C. E. A.
Winslow and Mr. Leonard Greenburg, of the Yale School of Medicine.
Particularly suggestive is a recent contribution on u Industrial tuber­
culosis and control of the factory dust problem/1 in the Journal of
Industrial Hygiene for February, 1921. These two authors jointly
with Mr. E. H. Reeves, scientific assistant, of the United States
Public Health Service, have issued a report on The Efficiency of Cer­
tain Devices Used for the Protection of Sand Blasters against the
Dust Hazard, published in the Public Health Reports of March 5, 1920.
Prof. Winslow, also with the assistance of Mr. Leonard Greenburg
and Mr. David Greenburg, scientific assistant to the United States
Public Health Service, published a paper on The Dust Hazard in the
Abrasive Industry, with particular reference to the incidence of
tuberculosis among workers exposed to mineral and metallic dusts.
INVESTIGATIONS OF UNITED STATES PUBLIC HEALTH SERVICE.

The subject is also covered in a report by Dr. Paul M. Holmes,
passed assistant surgeon, United States Public Health Service, in
Public Health Reports for January 2, 1920, on the Health Hazards
in the Industries of Niagara Falls. In an earlier report on Standards
for Measuring the Efficiency of Exhaust Systems in Polishing Shops,
Prof. Winslow, jointly with Messrs. Greenburg and H. C. Angermyer,
scientific assistant, United States Public Health Service, gave con­
sideration to the standards of air dustiness and involved technical
aspects of dust control, amplified by standards for ventilation appli­
cable to polishing shops. The most recent contribution is a report
on Tuberculosis Among Polishers and Grinders in an Ax Factory, by
Dr. W. Herbert Drury, contributed to Public Health Reports of
February 4, 1921. In this investigation local mortality data were
utilized, the tuberculosis death rate of polishers and grinders having
been determined for the period 1900-1919 as having been 19 per
1,000, compared with 1.6 for other persons in the mill and 2 for the
general population of the mill district. It was also ascertained that
the mortality from pulmonary infections other than tuberculosis was
4.3 per 1,000 of population for polishers and grinders, as against 1.7
for other mill employees. The investigation, while too limited in
plan and scope to warrant entirely safe conclusions, nevertheless in
the main supports the corresponding investigation for granite cutters,
emphasizing the importance of localizing the dust hazard and the
resulting mortality.
UNREALIZED PROMISES OF PREVENTION.

The foregoing investigations are the most encouraging indication
of the gradual accumulation of trustworthy data useful as a basis for
community action along effective preventive lines. The whole­
hearted cooperation of the labor organizations interested in the pres­
ent investigation also foreshadows a broader interest on their part in
preventive measures that will prove productive of results. The day
has gone by when there was justification for phrases and platitudes
such as perhaps were unavoidable at the outset of the campaign
against tuberculosis. Those who rendered assistance in the organiza­
tion of the movement and who have given furtherance to its plans




10

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.

and purposes have reason to feel satisfied with the results and
disappointed at the failure to do better. It is just 12 years since Mr.
John A. Kingsbury, in the American Review of Reviews for April,
1910, published an article on “ No tuberculosis in New York State in
1920.” The article is illustrated by a picture of a brass band em­
ployed to rally audiences for the New York State tuberculosis cam­
paign. In a concluding sentence Mr. Kingsbury remarks, with ref­
erence to the method referred to: “ These, it is admitted, are revival
methods^ but they stand the pragmatic test— they work. They not
only get the people out, but they get the people stirred to actioil.
To every one who attends these meetings the fact is brought home
poignantly that 16,000 lives are sacrificed annually in New York
State to a preventable disease, and that something must be done
about it now.” The question may properly be raised as to what
actually has been done to reduce materially and effectively the mor­
tality of 16,000 deaths referred to when the estimated mortality
from tuberculosis in New York State during 1920 was placed by
the authorities at 13,000!
IMPORTANCE OF OCCUPATIONAL DISEASE RECOGNITION.

The present discussion is intended to reemphasize the industrial
aspects of disease along lines of prevention which can not possibly
fail. If the dust hazard is the causative factor in the enormous
respiratory disease mortality of granite and other stone workers and
if preventive means are possible by which the dust menace can be
brought under control, it is for the State, for the labor organizations,
and for the industries concerned to see to it that what can be done
about it is done without needless delay.
SCOPE OF INQUIRY.
In its final analysis and as a practical question the problem of
pulmonary tuberculosis and of nontuberculous respiratory diseases
in modern industry is primarily one of dust control, or the prevention
of atmospheric pollution as a condition precedent to wholesome
methods of work essential to health and life. In no industry is this
question of greater importance than in the manufacture of stone
products, in which, since the introduction of pneumatic tools for
cutting and carving purposes, the dust problem has attained to the
proportion of a deadly menace to the workers, who are as yet but
vaguely aware of the risk incurred by injudicious dust exposure
during processes frequently admitting of no effective methods of
meohanical control.
The mortality figures of stone workers have for many years indi­
cated a general death rate above the normal for indoor occupations,
particularly from lung diseases generally diagnosed as pulmonary
tuberculosis. More often, however, the prevailing diseases are of the
nontuberculous or of the fibrotic type best illustrated by the so-called
“ miner’s phthisis,” which in a large proportion of cases is nontuber­
culous and as such named variously pneumoconiosis, silicosis, etc.
As yet the investigations into the true nature of the problem of dust
phthisis are far from sufficiently extensive to be really conclusive as
a basis for drastic and practically possible methods of prevention.




SCOPE OF INQUIRY.

11

Even more lamentable, however, is the prevailing apathy to the known
facts of a situation which must be looked upon as of the very first
importance to the worker, whose toil is an indispensable contribution
to the welfare of mankind.
METHOD OF INQUIRY.

For the purpose of determining with at least an approach to scien­
tific accuracy the mortality facts of the stone industry the present
investigation was undertaken, and it has had the hearty cooperation of
official authorities, labor organizations, manufacturers, etc. The in­
vestigation is a continuation of the investigation the results of which
are reported in Bulletin No. 231 of the United States Bureau of
Labor Statistics, on Mortality from Respiratory Diseases in Dusty
Trades, in which the stone industry is given preliminary considera­
tion, including observations on marble, slate, and limestone workers.
Since that investigation includes general observations on dust
phthisis, it would not seem necessary to enlarge upon the underlying
considerations illustrated in a more concrete form in the present
case. After a careful reexamination of the data derived from general
experience in dusty trades the granite industry was selected as prob­
ably the best illustration of the health-injurious consequences of
long-continued inhalation of inorganic, silicious dust. It also seemed
advisable to limit the investigation chiefly to the Barre stone-cutting
industry of the State of Vermont, partly on account of the hearty
cooperation of the State board of health, which provided facilities
for an examination of death certificates extending over a long period
of years.
The investigation also had the exceptional advantage of the assist­
ance of the local labor unions, subsequently extended to include the
entire experience of the Granite Cutters’ International Association of
America. In addition, the manufacturers of the district provided the
necessary facilities for shop inspections, interviews with workmen, and
the examination of dust-removing devices in operation at the present
time. Assistance was also rendered by the Commissioner of Indus­
tries of the State of Vermont, the State Commission on Dusty Trades,
and the Vermont Tuberculosis Association, Inc. Through these
agencies and by means of accepted methods of inquiry a large amount
of entirely new statistical and other material was collected and ampli­
fied by the industrial mortality experience of the Prudential Insur­
ance Co. of America. This material has been brought together for
the present purpose and is now presented as suggestive of a method
of inquiry giving promise of really practical and far-reaching results.
The general vital statistics utilized for the present purpose have
all been derived from the official reports of the several States, par­
ticularly: Annual Reports upon the Births, Marriages, Divorces,
and Deaths in the State of Maine; Biennial Reports Relating to the
Registration and Return of Births, Marriages, Divorces, and Deaths
in New Hampshire; Annual Reports of the State Board of Health
of the State of Vermont; Annual Reports on the Vital Statistics of
Massachusetts; Annual Reports Relating to the Registry and
Return of Births, Marriages, and Deaths, and of Divorce in the
State of Rhode Island; Registration Reports of the Bureau of Vital
61-928°— 22— Bull. 293-------2




12

DUST PH TH ISIS IK TH E GRANITE-STONE INDUSTRY.

Statistics of the State of Connecticut; Mortality Statistics of the
United States Bureau of the Census. Population statistics have all
been derived from the Census Reports of the United States Bureau
of the Census or the Decennial Census Reports of Massachusetts.
Population estimates for intercensal years have been arrived at by
the arithmetical method. The population estimates were com­
pleted before the results of the census of 1920 were available.
OCCUPATIONAL DISEASES OF THE STONE INDUSTRY.

By way of introduction, the general problem may be stated in the
following extract from Kober and Hanson’s Diseases of Occupation
and Vocational Hygiene (p. 625). Regarding stonecutters and marble
workers it is said:
These occupations have from time immemorial been regarded as inimical to health,
and even Ramazzini, in the first book on Occupational Diseases, calls attention to the
fact that the inhalation of the dust incident'to hewing, cutting, and polishing of marble
or of stone produces a troublesome cough, and that a goodly number of the operatives
become asthmatic and consumptive. We know now that the inhalation of mineral
dust develops sooner or later pneumoconiosis, which may eventuate in pulmonary
tuberculosis. It is generally held that the liability to diseases of the respiratory pas­
sages is less in the case of paving-stQne cutters and slate splitters and in the sawing,
grinding, polishing, and lathe work, which can be conducted by the wet process,
than in the case of monument or custom work, and particularly in the surfacing, carving,
and cutting with pneumatic tools. The greatest amount of dust is evolved by th 3 sur­
facing machines which are operated with compressed air. Of the various tools em­
ployed, the bushing hammer creates the finest dust. Unfortunately work with
pneumatic tools can not be done by the wet process, as the pasty material created by
a mixture of water and dust clogs up the tools. The work is usually done in large
open sheds or in the yards, but even under such conditions the men are exposed to
clouds of dust. The sawing of granite and marble into slabs, turning in lathes, and the
final polishing can be conducted by the wet process; soapstone sawing and cutting for
joints is frequently done drv and is attended with exposure to considerable dust.
IMPORTANCE OP OCCUPATIONAL SEGREGATION.

The foregoing observations concern stonecutters and marble
workers as a group, but it will be shown by the present investigation
that it is of the first importance that each type ot stone-dust exposure
should be s e p a r a t e l y considered, as the inclusion of dissimilar stone
workers in a group in mortality investigations is certain to lead to
erroneous conclusions regarding individual occupational hazards.
For example, in the article referred to there occurs the statement
that “ in analyzing the statistics of the towns in the State of Vermont,
where most oi the granite and marble industry is carried on, the writer
found that Barre, Montpelier, Rutland, Proctor, Dorset, Hardwick,
Bethel, and Ryegate, with a combined population of 34,889, had a
tuberculosis death rate of 2.2 per 1,000 of population, against a rate
of 1.3 for the entire State.”
Hence for other than the most general purposes the inclusion of
marble workers with those engaged in the cutting and polishing of
granite is clearly unscientific. Unfortunately no comprehensive
investigations have as yet been made into the mortality of marble
workers, but from preliminary inquiries it would appear to be an
entirely safe conclusion that the exposure to marble dust is much
less harmful than the continuous inhalation of granite dust. All
investigations regarding the health-injurious nature of stone-dust
exposure require then to be considered with reference to the nature




SCOPE OF INQUIRY.

13

of the dust inhaled, for wide variations in mortality rates are met
with when the chemical and mechanical properties of the dust are
taken into account. Even so careful an observer as the late J. T.
Arlidge in his treatise on the Hygiene, Diseases, and Mortality of
Occupations (p. 303) made the error of reasoning from an entirely
inadequate basis of observed experience regarding workers in granite,
stating that:
From special inquiries I have made it would appear that the numerous hands
employed around Aberdeen in the cutting, dressing, and polishing of grani te are seldom
victims of pulmonary lesions attributable to their occupation. This may be esteemed
an unexpected fact, considering the density of granite and its lithological elements, f
Prof. Hamilton, of Aberdeen University (in a private letter), seeks an explana­
tion from the igneous character of the rock, which opposes itself to the throwing off
of dust, because its particles, unlike those of stratified rocks, do not exist in granite
ready formed, but require to be made by the chisel of the workman. “ The dust
in granite working would in all likelihood be coarser than in chiseling stratified rock,
and would be caught in the superior respiratory passages without gaining entrance
to the air vesicles, where alone it seems to make its way into the pulmonary lym­
phatics.”
But whatever be its explanation, the fact remains, confirmed by several medical
men of large experience in Aberdeen, that, though they suffer somewhat from chronic
bronchitis, the severe lesions indicative of fibrosis and industrial “ phthisis” are
almost unknown among the masons and polishers in the Aberdeen quarries.

It will.be shown that workers in the Aberdeen district suffer most
seriously from pulmonary tuberculosis and from nontuberculous
respiratory diseases, and while as yet no exact analysis has been
made of the petrological character of the stone dusts from Aberdeen
as compared with those from Edinburgh or the dust samples collected
in the stone centers of th^s country there are convincing reasons for
believing that the mortality rate will be found to vary largely in
proportion to essential differences in the mechanical and chemical
properties of the dust inhaled (see p. 22 et seq.).
PATHOLOGY OF DUST INHALATION.

In this connection the following observations by Arlidge (pp.
245, 246 of his treatise) on the pathology and symptomatology of
dust inhalation are of much practical value:
Bronchitis, asthma, fibroid and tubercular consumption occupy a foremost place
in the category of causes of British mortality; and without doubt these maladies are
largely attributable to the inhalation of dust, operating per se or in conjunction with
constitutional proclivities and insanitary surroundings. Pathologists tell us of the
presence of bacilli in tubercular disease, and favor the belief that these minute bodies
are the cause of it. This notion may represent a whole truth or only a partial one;
in my opinion, the latter, for I doubt if these bacilli actually develop phthisis, unless
there be some antecedent change in the vitality of the affected tissue; a change
wrought b>y depressing causes connected with the mode of life, or with constitutional
debility and inherited taint, or with the occupation followed, of which contributory
factors two or more may cooperate. And assuredly the breathing of dust may be
reckoned as one such of no slight energy. In other words, I look upon a phthisical
lung as one prepared for the germination and multiplication of bacilli and not a
primary product of those microscopic organisms, nor of the products of their organic
existence. And I find an analogy in the vegetable kingdom, where failing plant
vigor is the precursor of the appearance of devastating fungi, and not the fungi the
starting point of plant death. The spores of fungi light upon a tissue in which vital
forces are failing and allow the development of abnormal fluids, and in the altered
organic matter those spores find a suitable nidus for growth. Having established
themselves, the fungi now become active agents in breaking down the vegetable
tissues. Plants full of vigor will resist the attacks of fungi falling upon them from
neighboring plants of the same species.




14

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

So it is, I believe, with bacilli; they require a weakened tissue to give them
foothold; but having got it, their vast powers of propagation and the transforming
action of their vitality on surrounding material render their action highly destructive.
That the injection of bacilli into the blood will start tuberculosis is a fact that does
not contravene the foregoing view. They have thereby obtained a nonnatural access
by the agency of the blood, which brings them into immediate relation with tissues
in process of degeneration or of decay, that is, with tissues in a state of weakness
and unable to resist their attacks as epiphytic organisms: on the one hand abstracting
from them the necessary elements for complete formation, and, on the other, poison­
ing the plasma by metamorphosed products, the result of their own vital endow­
ments.
_ It must be accepted as a fact that dust induces a malady bearing a strong similitude
to tubercular phthisis and yet that the malady is not tubercular in its actual nature.
In cases of potters’ consumption from inhaled dust, occurring under my own
observation, bacilli have been sought in vain, excepting where hemoptysis, hectic,
and other indications that tubercular mischief has been at work, as accessory or
collateral. For experience proves that the dust-produced lung disease may coexist
with tubercular phthisis, and, further, that where labor is prosecuted in a dusty
atmosphere tubercular mischief in those constitutionally predisposed to it is more
likely to arise.

The present investigation would seem fully to support this im­
portant conclusion, leading to the conviction that in many cases the
diseases reported as pulmonary tuberculosis should be more ac­
curately defined as nontuberculous respiratory diseases generally
comprehended under the term “ fibrosis,” for in many cases it will
not be found possible to establish the tuberculous nature of the
disease by positive bacteriological findings.
New conceptions as regards the true nature of the tuberculous
infection in the human organism are of such complexity that they
can not possibly be dealt with on this occasion. The view seems to
be gaining ground that the soil is more important than the seed and
that the chief protection of the individual lies in a maximum of
disease resistance. According to a recent statement illustrating
this new conception Dr. Edgar L. Collis is quoted as follows:
Professor Collis dealt with stone masons' phthisis or tuberculosis of the lungs, as
to which it has generally been considered that the stone dust which the mason inhales
acted as sharp-edged particles lacerating and irritating the lining of the air passages.
Professor Collis has shown, however, that the silica (quartz) of the stone dust acts
rather as a chemical than as a physical agent, rendering the membrane a better growthsupporting medium for tuberculosis bacilli.

PREVIOUS INVESTIGATIONS IN THE STONE INDUSTRY.
ANCIENT ORIGIN OF THE STONE INDUSTRY.

The stone industry is one of the very oldest as well as most widely
diffused occupations. Prof. Edgar L. Collis in his Milroy lecture on
Industrial Pneumoconiosis (p. 3) draws attention to the extraordinary
incidence of lung disease among the flint knappers of Brandon, the
lineal representatives of prehistoric employments for the making of
stone implements, pointing out the interesting fact that—
The flint knappers of Brandon, the lineal occupational representatives of this the
oldest of industries, who still use tools similar in shape to the deer-horn picks of their
prehistoric ancestors, suffer a terrible mortality from phthisis induced by flint dust
generated in their work; and early last century Bourgoin pointed out the ravages
produced among the population of Meusnes in France by the introduction of the gunflint industry. “ By a fate,” says Chateauneuf, “ which seems connected with all
that concerns the art of war this industry slays those who follow it; it kills them before




PREVIOUS INVESTIGATIONS IN TH E STONE INDUSTRY.

15

their time; for them there is no old age. When asked the cause of so premature a
mortality, doctors and officials give the same reply— pulmonary phthisis induced by
prolonged inhalation of dust generated from working flints. ” Probability suggests,
therefore, that the starting point of human progress was associated with at least one
form of industrial pneumoconiosis and that, if tuberculosis affected prehistoric man,
the mortality experienced must have been as severe as that found in existence to-day.

Prof. Collis has enlarged upon this problem in his evidence before
the Royal Commission on Metalliferous Mines and Quarries,3 suggesing a brief reference to a recent communication of the writer in the
Scientific American, December 23, 1920, on the question of “ Why the
cliff dwellers vanished/7in which the causative factor for the complete
disappearance of this interesting fragment of population is attributed
to the serious and continuous dust exposure in the making of stone
implements, in the literally carving o f rock shelters out of the solid
stone, in the making of flint arrowheads and stone tools, and, finally,
in the carrying on of the pottery industry. The amount of dust
exposure must have been enormous and even more fatal than under
modern conditions of stonework with pneumatic tools.
Collis gives a proportionate mortality of 77.8 per cent for phthisis
in the case of the Brandon flint knappers, as against 11.2 per cent for
all males 15 years of age and over in England and Wales, 1900-1902.
The calculated death rates per 1,000 (though based on small numbers)
are given as 41.0 and 1.6, respectively, Yet the wives of these work­
men were singularly exempt from a liability to phthisis, no deaths
at all having occurred among them, though for the Brandon rural
population the observed proportionate mortality was 6.5 per cent as
compared with 77.8 per cent for the flint knappers. It is most
regrettable that this interesting experience should not have been
reported upon in more detail and continued down to date.
ABERDEEN MORTALITY INVESTIGATIONS.

The same conclusion applies to the interesting and important data
for the city of Aberdeen, Scotland, reported upon by Dr. Matthew
Hay, in his annual report as medical officer of health for 1909.4 Since
this report is practically inaccessible and rarely referred to in the
literature of tuberculosis or industrial hygiene, the more important
observations are given in full, as follows:
Considerable interest attaches in Aberdeen to the incidence of phthisis among stone­
cutters and masons, owing to their considerable number and to the danger to 'tfhich
they are exposed from the inhalation of granite dust. All masons are not, however, so
exposed, as a proportion of them, varying with the character of the building, are
employed solely in building and are known within the trade as “ wallers, ” while the
remainder are engaged in hewing and dressing stones. Wallers are not so distinguished
in the death registers. Nor is any distinction made in the registers between masons,
whether hewers or wallers, employed in connection with buildings and stonecutters
employed in the numerous monumental yards. As a rule, a hewer working in the
latter is known as a stonecutter, but he is not infrequently designated a mason.
In calculating the death rate among hewers it has been found necessary to form
masons and stonecutters into one group and to include wallers. As wallers are not
exposed to the inhalation of dust and presumably do not suffer more from phthisis
than the average workman in other trades, their inclusion in the group tends to lower
the death rate from phthisis; but after careful inquiry I am of the opinion that their
8 Minutes of Evidence Taken Before the Royal Commission on Metalliferous Mines and Quarries, Vol.
II, p. 262, London, 1914.
* For more recent statistics, see pp. 149-152.




16

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.

proportion in the whole group during the past 10 years has not exceeded one-seventh,
owing to the large number of stonecutters in the monumental yards.
Stone polishers and stone sawyers form a separate group, as the processes in which
they are engaged are wet processes and not accompanied with dust.
For all the occupations dealt with I have omitted persons under 2 1 years of age— 1
that is, roughly, all apprentices—as they vary considerably in their proportion and
in their age at entrance in different trades. I have also excluded masters, who are
usually not exposed to the same occupational risks as their workmen.
I have given, for comparison, the deatii rate from all other causes of death, and have
separately distinguished lung diseases other than phthisis, as also diseases of the
circulatory and nervous system. The last two are taken together, owing to consider­
able changes recently in their classification.

The statistical analysis includes the deaths during a 10-year period
(1900-1909) derived froni trade-union experience. For purposes of
comparison the data are also given for a number of other important
occupations.
The number of deaths from phthisis during the period under
consideration was only 99 for stonecutters and masons and 11 for
polishers and sawyers, but the results are most suggestive of condi­
tions as much neglected by the authorities in Scotland as they are
in this country. For stonecutters the proportionate mortality from
phthisis was 31.0 and for all lung diseases 45.0. For stone polishers
and sawyers the proportion for phthisis was only^ 14.0 and for all
lung diseases 38.0. For ordinary laborers the investigation dis­
closed a proportionate mortality of 9.0 and 31.0, respectively.
The average annual number of stonecutters and masons exposed
to risk was 1,750 and of polishers and sawyers 420, giving a phthisis
death rate of 5.7 per 1,000 for the former and 2.5 for the latter.
These rates are for employees only. For the wives and widows
of stonecutters and masons the phthisis death rate was 1.8 and
for those of polishers and sawyers 1.6 per 1,000, which com­
pares with rates of 1.7 for the wives and widows of painters, 1.9 for
those of bakers, and 2.1 for those of laborers. The following inter­
esting observations on these tables will best emphasize the main
conclusions drawn from the investigation.
Table B [2] shows that stonecutters and masons stand above all the others with a
death rate (5.7 per 1,000) from phthisis that is three times as high as the average (1.9)
for males above 21 years. If allowance is made for the inclusion of wallers, among
whom the mortality from phthisis can scarcely be higher than the average, the death
rate among persons actually engaged in the cutting and hewing of granite is probably
about 6 .2 per 1 ,0 0 0 .
As. a rule, occupations with a high mortality from phthisis have also an increased
mortality from other lung diseases. This is not the case with stonecutters and masons
in Aberdeen, or with printers or lithographers, or with clerks. In all three occupa­
tions the mortality from other lung diseases is under the average. Tailors and comb
makers, however, follow the .usual rule, having a somewhat high mortality from other
lung diseases. The result is that if the rates for phthisis and other lung diseases are
combined tailors and comb makers, with 8 . 8 and 8 . 6 per 1 ,0 0 0 , respectively, take
precedence of stonecutters and printers, with 8.2 and 5.6, respectively.
The proportion of old men engaged in stonecutting is lower than the average, and
this is more distinctly the case with printers, and especially with clerks. On the
other hand, the proportion of old men among tailors is nigh, and it is probably fairly
high among comb makers.
The necessary age corrections, without overemphasizing details, are made in Table
C [3], differentiating ages under and over 55 years. This table confirms the previous
conclusions as regards the excessive incidence of phthisis among stonecutters not
only at the younger ages but even more so at ages 55 and over.




PREVIOUS INVESTIGATIONS IN THE STONE INDUSTEY.

17

TABLE 1__ N U M BER OF D EATH S OF PERSONS O V E R 21 Y E A R S OF AG E (EXCLUDINGEM PLOYERS) IN A B E R D E E N , 1900 TO 1909, AND PROPORTION D Y IN G FROM LUNG
DISEASES, B Y OCCUPATION.

Occupation.

Total number of deaths from—
Esti- •
mated
average
annual
Lung diseases.
number
Circulaof em­
Other
ployed
and
dis­
persons
nervous eases.
Includ­
Exclud­
over 21
dis­
ing
ing
years Phthi­
eases.
sis.
phthi­ phthi­
of ag«.
sis.
sis.

Per cent deaths
from phthisis
and all lung
diseases are of
deaths from all
causes.
All
causes.
Phthi­ All lu£g
dis­
sis.
eases

Males.
Stonecutters and masons___
Stone polishers and sawyers.
Joiners, sawyers, shipwrights,
and cabinetmakers...............
Painters.....................................
Tailors................................
Bakers.......................................
Engineers, blacksmiths, riv­
eters, and firemen...............
Printers and lithographers...
Comb makers...........................
Carters.......................................
Laborers....................................
Clerks.........................................

1,750
420

99
11

43
21

142
32

80
21

94
23

316
76

31
14

45
38

1,420
420
620
360

26
9
20
5

48
17
35
16

74
26
55
21

99
39
56
23

122
22
53
30

295
87
164
74

9
10
12
7

25
30
33
29

2,600
380
345
1, 450
3,600
1, 220

47
17
15
16
81
46

60
4
15
45
203
18

107
21
30
61
284
64

134
17
25
44
299
48

126
14
23
72
352
66

367
52
78
177
935
178

13
33
19
9
9
26

29
41
38
34
31
36

1, 750
3,500

34
74

26
116

60
190

47
238

57
310

164
738

21
10

37
26

Females.
Dressmakers and milliners...
Domestic servants............... ..

T

able

2 .—A V E R A G E A N N U A L D E A T H R A T E OF PERSONS OVER 21 Y E A R S OF AGE
(EXC LUDING EM PLO YER S) IN A B E R D E E N , 1900 TO 1909, B Y OCCUPATION.

Occupation.

Annual number of deaths per 1,000 persons from—
Esti­
mated
aver­
T u b ercu losis.
Lung
age an­
nual
Circunumber
latory Other
of em­
and
All
ployed
Ex­
dis­
Wives
In­
Un­
persons Phthi­ cluding cluding nervous eases. causes.
married
and
dis­
above
sis.
chil­
wid­
.phthi- phthi- eases.
21 years
ows.
dren.
of age

Males.
Stonecutters and masons___
Stone polishers and sawyers.
Joiners, sawyers, shipwrights,
etc..........................................
Painters...................................
Tailors......................................
Engineers, blacksmiths, etc
Printers and lithographers. .
Comb makers..........................
Carters......................................
Laborers..................................
Clerks...........................

5.7
2.5

2.5
4.8

6.2

4.6
4.8

5.4
5.2

1,420
420
620
360
2,600
380
345
1,450
3,600
1,220

1.8
2.1

3.4
4.0
5.6
4.4
2.3

6.1
8.8

5.2

7.0
9.3
9.0
6.4
5.2
4.5
7.2
3.0

5.2
8.5
8.3
4.8
3.7
6.7
5.0

1,750
3,500

2.1

1,750

3.2
1.4

1.8
4.5
4.3
LI
2.3

1.1

1.9

1.5
3.5

4.3
3.1
5.6
1.5

7.3

5.8
4.1
5.6

8.6
4.2
7.9
5.3

18.1
17.3
20.8
20.7
26.5
20.6

14.1
13. 7
22.5

12.2
26.0
14.6

Females.
Dressmakers and milliners. . .
Domestic servants.............
All males 21 years and over,
irrespective of employment
All females, 21 years and over,
irrespective of employment




3.4
5.4

1.9

5.2

5.6

1.7

4.4

5.1

2.7

9.4

2.7

6.8

21.1

8.0

18.8
17.8

1.8
1.6
1.8

4.7
5.5

1.7
1.6
1.9
1.6

3.7
4.5
2.7
4.4
3.9

1.8
2.1
1.1

3.2
4.7
4.4
0.7

1.1
2.0

1.6

18

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

T a b le 3 .—NUM BER OF D E A T H S, GROUPED ACCORDING AS AG E W AS U N D E R OR
OVER 55 Y EAR S, AMONG PERSONS OVER 21 Y E A R S OF AG E (E XC LU D IN G EM­
PLO YER S) IN SPECIFIED OCCUPATIONS IN A B E R D E E N , 1900 TO 1909, AN D D E A T H
R A T E FROM LUNG DISEASES OF THOSE U N D ER 55 Y E A R S OF AGE.
Total number of deaths from—
Per
cent of
person?
over 55
Other lung dis­
Phthisis.
years
eases.
of age
esti­
mated
Under Over Under Over
from
55
55
55
55
census
of 1901. years. years. years. years.

Occupation.

Number of deaths of
persons under 55 years
per 1,000 persons un­
der 55 years.

Phthi­
sis.

Other
lung
dis­
eases.

All
lung
dis­
eases.

Males.
Stonecutters and masons....................
Stone polishers and sawyers.................
Joiners, sawyers, shipwrights, etc___
Painters....................................................
Tailors
.
Bakers.......................................................
Engineers, blacksmiths, etc.................
Printers and lithographers...................
Comb makers..........................................
Carters.......................................................
Laborers...................................................
Clerks.......................................................
Females.
Dressmakers and milliners...................
Domestic servants..................................

9
10
16
7
16
7
12
5
15
8
22
' 6

77
9
24
9
17
4
44
17
13
15
67
46

22
2
2
0
3
1
3
0
2
1
14
0

14
9
12
7
7
10
26
2
2
26
71
10

29
12
36
10
28
6
34
2
13
19
132
8

4. 9
2. 4
2.0
2.3
3. 2
1. 2
1. 9
4.7
4. 5
1.1
2. 4
4. 0

0. 9
2. 4
1.0
1. 8
1. 3
3. 0
1.1
.6
.7
1.9
2. 5
.9

5 .8*
4.8
3.0
4.1
4.5
4.2
3.0
5.3
5 2
3.0
4.9
4.9

11
10

33
66

1
8

7
26

19
90

2.1
2. 2

.5
.9

2.6
3.1

2.1

1. 5

1.9

.8

All males 21 to 55 years, irrespective
of employment.....................................
All females 21 to 55 years, irrespective
of employment....................................

3.6
2.7

AGE INCIDENCE IN DUST PHTHISIS.

It is further said that—
Attention may be directed to the exceptionally large number of deaths from phthisis
among stonecutters after the age of 55. In nearly every other occupation, except
that of laborers, phthisis is relatively rare as a cause of death after this age; and it is
possible that, so far as concerns Aberdeen, the considerable number of deaths from
phthisis among older laborers is in part due to the presence among them of former
stonecutters. Among 1,750 stonecutters and masons there were during the past 1 0
years 2 2 deaths from phthisis of persons above 55 years of age. Among 3,600 laborers
there were 14 deaths. In the 9,235 other male persons dealt within the tables there
were only 14 deaths. Many cases of phthisis in stonecutters must either have begun
late or lasted long. _Such may be cases of persons with little constitutional predispo­
sition to tuberculosis in whom the tubercle germ only succeeds in overcoming the
greater vital resistance after a protracted struggle.

Attention is also directed to the fallacy of the average age at death
as an index figure of mortality, since a low average age by no means
consistently coincides with a high death rate, as is frequently assumed
to be the case. The source of the fallacy is in a large measure to be
found in the varying age constitution of the occupational groups and
also, no doubt, to a widely varying length of trade life. No average
age at death would therefore reveal the truly enormous differences
in the increased liability of stoneworkers to pulmonary phthisis.
For illustration, in the Aberdeen experience the average age at death
from phthisis was 43 years for stonecutters and the same for stone
polishers, against 41 years for laborers and 30 years for clerks, while
the phthisis death rates per 1,000 were 5.7 for stonecutters, 2.5 for
polishers, 2.3 for laborers, and 3.8 for clerks. In commenting on
these divergent figures it is said that—




19

PREVIOUS INVESTIGATIONS IN THE STONE INDUSTRY.

Two of the occupations (stonecutting and comb making) with the highest death rate
from phthisis are the two occupations with the highest average age at death from that
disease. Both are dust occupations. There is some ground for believing, not only
from these figures but from the results of similar investigations elsewhere, that dustproduced phthisis is, in many cases, slow in leading to a fatal result. On the other
hand clerks with a high death rate from phthisis have a low average age at death
from that disease. This, no doubt, is in large part due to age constitution, but it
suggests the question whether phthisis caused by vitiated air, as in small ill-ventilated
offices, and occurring among persons working with the chest in a cramped position,
does not tend to a speedier issue. The figures for tailors are rather opposed to this
view. The four occupations with the lowest death rates from phthisis— namely,
carters, bakers, engineers, and joiners—have average ages at death from that disease
of 38, 39, 38, and 36, respectively. These ages, as compared with those for other
occupations, are neither high nor low.
EFFECT OF PNEUMATIC TOOLS.

Aside from the foregoing general statistical observations, the
report by Dr. Hay considers the question, of special practical im­
portance, as to the effect of pneumatic tools as a factor in the mor­
tality from phthisis. These observations are of such exceptional
value that they are given almost in their entirety as contained in the
original report:
In regard to the mortality from phthisis among stonecutters and masons, the question
has been raised as to whether the introduction of pneumatically driven tools, which
produce more fine dust than the old hand chisels, has increased the amount of phthisis
and lung disease. I am informed that previous to 1900 very few pneumatic tools were
in use in Aberdeen. Between 1900 and 1905, and especially after 1902, their use
rapidly extended, so that by 1905 they had come into full use in practically all stonecutting yards.
The following table gives the number of deaths among stonecutters and masons
combined for each of the 15 years ending with 1909. The first five years (1895-1899)
represent a period practically unaffected by pneumatic tools, the second five years
(1900-1904) a period in which pneumatic tools were coming into use, and the third
five years (1905-1909) a period in which the tools were in full use. Only deaths at
ages of 2 1 years and upwards are included.
T a b l e 4 . — NUM BER

OF DEATHS AMONG STONECUTTERS AN D MASONS COM BINED
FROM PHTHISIS AND OTHER LUNG DISEASES, 1895 TO 1909.
Cause of death.

1895

1896
First

1897

1898

period

1899

Total.

(1895-1899).

Phthisis...............................................................................................
Other lung diseases...........................................................................

6
5

9
1

12
5

7
9

13
8

47
28

Total.............................................................................................

11

10

17

16

21

75

Second period (1900-1904).
1900

1901

1902

1903

1904

Total.

Phthisis...............................................................................................
Other lung diseases...........................................................................

10
6

6
10

13
5

12
2

9
8

50
31

Total.............................................................................................

16

16

18

14

17

81

Third period (1905-1909).
1905

1906

1907

1908

1909

Total.

Phthisis...............................................................................................
Other lung diseases..........................................................................

11
2

10
3

9
3

11
1

8
3

49
12

Total.............................................................................................

13

13

12

12

11

61




20

BUST PH TH ISIS IN THE GBANITE-STONE INDUSTEY.

The numbers for 1900-1904 are slightly above those for 1895-1899 in respect both
of phthisis and of other lung diseases. The total number for 1905-1909 is, however,
considerably down; but the fall is practically confined to deaths from lung diseases
other than phthisis.
The first two periods are fairly comparable, except that allowance should be
made for an increase of perhaps 1 0 per cent in the number of persons employed as
between the first and second periods and for the fact that during these two periods
the mortality from phthisis in the community as a whole was falling. As probably
the effect of the latter influence did rather more than equalize the effect of the former,
a comparison of the first two periods would appear to show that the introduction of
pneumatic tools had produced some increase, although not a large increase, in the
death rate from phthisis and other lung diseases.
As regards the third period (1905-1909), while the number of stonecutters and
masons employed in monumental yards has not fallen off, but rather increased, there
has been a great decline in the number of building masons in employment, due to
unusual depression in the building trade. Some of these out of employment as
mason hewers have, I believe, found employment as stonecutters in monumental
yards, and thus checked in some measure the advancement of apprentices to the
status of journeyman. Some have emigrated to America. Some have drifted into
laboring, but not improbably in the event of death within two or three years of leaving
their trade their deaths have been registered by their relatives as the deaths of masons.
It is difficult to know to what extent to make allowance for these disturbing factors.
Probably any reasonable allowance would not raise the total number of deaths from
phthisis and other lung diseases combined above or even up to the number for each of
the two preceding quinquennial periods, but it would raise the number of deaths
from phthisis above th« numbers for these periods.

The difficulties emphasized are common to all inquiries of this
kind, but probably somewhat more seriously in the case of the
Aberdeen district than of Barre, Vt., where, however, a large number
of former Aberdeen cutters have been actively at work for many
years.
The workmen employed at stonecutting in monumental yards are usually known
as stonecutters, although sometimes called masons, while those employed in building
yards are usually called masons, although sometimes designated as stonecutters. If
we take the deaths of persons during the past 15 years who when they died were regis­
tered as stonecutters, we find that in the three 5-year periods, beginning T\ith the
first, the number of deaths was 29, 28, and 36, respectively. This gives an increase
of eight deaths in the third period as compared with the second period, or an increase
of nearly one-third. If, however, the deaths from other lung diseases are added, the
figures for the three periods become 39, 43, and 42. Allowing for an increase of work­
men over the 15 years, these figures would not appear to indicate any appreciable
increase in mortality; but they must be viewed in the light of the fact that since
1895-1899 the mortality from phthisis and other lung diseases in the city generally has
fallen very considerably. The conclusion must therefore be that the introduction of
pneumatic tools has prevented stonecutters sharing in the general decline in the
death rate from lung diseases. It is of interest to add that the average age at death of
stonecutters dying of phthisis and other lung diseases has risen considerably, being
for the three 5-year periods, 36, 44, and 46 years, respectively.

Other difficulties met with in an exact determination of the facts
are illustrated by the following extract:
About the time of the introduction of pneumatic tools for granite cutting, but not
altogether as a consequence of it, the sheds, which had usually been entirely open
along the front, as in the case of an ordinary builder’s shed, began to be closed. The
closure, while increasing the liability to the inhalation of dust, must at the same time
have afforded some protection against cold and possible chills. This may possibly
account in part for the diminution during the past five years in the number of deaths
from lung diseases other than phthisis. But the numbers dealt with are small, and
allowance must be made for mere chance variations.
During all three periods the mortality from lung diseases other than phthisis has been
exceptionally low as compared with the rate in other occupations. The unusual com­
bination, in the case of workers in stone, of a high mortality from phthisis, with alow
mortality from lung diseases other than phthisis, may serve to bear out the statement
made by the late Prof. Hamilton, professor in pathology in Aberdeen for about 25




PREVIOUS INVESTIGATIONS IN THE STONE INDUSTRY.

21

years, and previously for several years pathologist to the Edinburgh Royal Infirmary,
that a deimate development of so-called lithosis, or a fibroid affection of the lungs
due to stone dust, is rare among granite workers in Aberdeen, although common a^nong
freestone workers in Edinburgh.
RACIAL AND SOCIAL INFLUENCES.

The same problem confronts an investigation into the facts of the
resent situation at Barre, and a much more extended inquiry than
as been possible would be required to determine with accuracy the
precise influence of the numerous occupational, social, and even
racial influences which more or less determine the death rate from
any particular disease during a given period of years. Of no small
importance in this connection are changes in the viewpoint of the
medical profession, which leans now toward one theory and now
toward another in matters of pathology, symptomatology, and
clinical diagnosis, as well as in the interpretation of autopsy findings.
Dr. Hay, in some detailed comments on a statement by the late
Prof. Hamilton, remarks:

E

I
have searched the post-mortem records of the Aberdeen infirmary for the past 15
years for information on this point, and have found few marked indications of lithosis
in stonecutters, whatever was the cause of death; but the autopsies of stonecutters
and masons are not numerous and do not amount to more than one in a year, whereas
the total deaths from all causes among such persons average about 30 yearly. In
only three autopsies out of 13 was a condition of lithosis stated to have been found,
and in only one case was it fairly well marked. In two of the cases tuberculosis was
mentioned as present. In one case the deceased was known to have been employed
for some time in the South in working with freestone.
PROBLEM OF FAMILY INFECTION.

To the foregoing is here added the following concluding passage
from a report which will always rank as one of the classics in the
early literature of diseases of occupations, reserving for future con­
sideration the incidental observations on the relation of occupational
phthisis to the mortality from tuberculosis among wives and children,
a question of only academic importance in the present discussion.
The remarks by Dr. Hay follow:
As I have a strong conviction as to the important part played by constitutional
susceptibility in the production of phthisis, I am of the opinion that the entrance to
all trades with a high mortality from phthisis should be guarded, as far as possible,
against the admission of youths with a definite family history of tuberculosis, or with
defective chest development, or with lung weakness. Each intending entrant should
be examined by a medical man and careful inquiry made into the health history of
his family.
In addition, every reasonable and practicable method for diminishing the dangers
attached to the trade should be enforced. In the case of stonecutters it would appear
to be possible, as in certain other trades accompanied by injurious dust, to devise
arrangements by which the duet might in large measure be drawn away from the
faces of the workmen.
IMPORTANCE OF STONE DUST ANALYSIS.

•
The present investigation, though limited largely to the Barre
district, confirms much of what has been said in connection with the
Aberdeen inquiry. Until an analysis has been made of the dust of
the Aberdeen stoue the most important link in the chain of compara­
tive evidence will be wanting. The comparison gains in interest and
value when the fact is taken into account that of the total of 1;137




22

DUST' PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

granite cutters in the Barre district in August, 1919, 557 were of
Italian parentage, 181 of Scotch descent, and 87 of Spanish. It
would make a most useful contribution to knowledge if the more
recent experience of Aberdeen and Edinburgh could be brought
together, and, if possible, in a form corresponding to the present
investigation. It would also be most useful if at the same time the
possibly varying methods of clinical diagnosis and objective autopsy
findings were made note of, for, as pointed out by Prof. Collis in a
learned discussion5—
These distinctions, implied or definitely stated, between the types of respiratory
trouble which follow inhalation of different dusts are the more notable, because even
to-day pneumoconioses are pigeonholed in clinical teaching as a single entity, ascribed
to exposure to any and every form of injurious dust, of which pulmonary fibrosis
sums up the pathological findings and phthisis the morbid result.

Prof. Collis quotes from the earlier report of the Royal Commission
on Metalliferous Mines and Quarries the remarks of Peacock,6 that—
The form of the disease in which there is local consolidation in some portion of the
lungs bears a close general resemblance to true consumption, and especially where,
as often happens, the voice is husky and the patient expectorates blood. There are,
however, features by which it is sufficiently distinguished from that disease. It
usually occurs in persons who do not present any hereditary disposition to phthisis,
their parents and other relatives often having attained advanced ages and being quite
healthy. It commences at a later period of life than phthisis; indeed, in persons
who have reached ages at which consumption is by no means of frequent occurrence.
It is also much slower and less active in its progress, so that in persons wTho have
been ill for several years the signs often do not indicate extensive or advanced disease.
The quickness of pulse, the rapid and extreme emaciation, and the night perspira­
tions so characteristic of true phthisis are also generally absent or only slightly marked,
and there is rarely diarrhea; indeed, the bowels are often obstinately confined.

These and other investigations confirm one another, leaving no
reasonable doubt that it is primarily the exposure to health-injurious
dust that determines the excessive incidence of occupational phthisis.
Yet neither the Government nor the medical profession during the
long intervening period of years has given the matter the requisite
amount of qualified consideration. Collis rather mildly observes in
his conclusions: “ Why work so well started was then allowed to lie
dormant for so long, while other aspects of public health were being
strenuously developed by medical officers of health, with inspectors
of nuisances appointed for every town and district, reinforced now by
a battalion of tuberculosis officersr is astonishing.”
MORTALITY AMONG GRANITE-STONE WORKERS.
ANALYSIS OF VERMONT GRANITES.

The present investigation was decided upon after most careful con­
sideration as covering probably the most typical of the so-called dusty
trades, and, while largely statistical, the outlook is most hopeful that
the supplementary investigations by the Bureau of Mines will add
a large amount of new, technical information urgently needed in pre­
ventive efforts of far-reaching importance to the trade. The investitation at the outset took into account the general facts of tubercuosis occurrence in the State of Vermont, and particularly in the
counties of Washington and Caledonia, in which'the major portion of

S

5 Milroy Lectures, 1915.
• Idem., p. 6.




-‘Industrial pneumonoconioses” , by Edgar L. Collis, M. B., p. 4.

MORTALITY AMONG GRANITE-STONE WORKERS.

the mills and quarries are located. The technical data regarding the
geographic distribution of the granites of Vermont, the geologic fea­
tures of the various quarries, and the descriptive accounts of the more
important beds have been reported upon in sufficient detail for the
present purpose in Bulletin No. 404 of the United States Geological
Survey (Washington, 1909). This publication includes a classification
of Vermont granites, reference to the texture of the stone and its
petrographic name, and analysis in some detail of a few types indica­
tive of a high silica content, as shown, for illustration, in the samples
of “ dark Barre granite” (p. 51) and the “ Bethel granite” (p. Ill), as
given below:
T a b l e 5 . — CHEMICAL

ANALYSIS O F GRANITE SAMPLES.

Constituent.

Silica..........................................................
Alumina...................................................
Soda...........................................................
Potash.......................................................
Lime..........................................................
Iron oxide.................................................
Other elements........................................

Dark
Barre
granite.

Bethel
granite.

Per cent.
69. 89
15.08
4. 73
4.29
2.07
1.46
2.48

Per cent.
77.52
16. 78
1.21
.62
2.56
.84
.47

100.00

100.00

This comparison would seem sufficient for the present purpose to
emphasize the material differences in the composition of the Vermont
granites, but since the mineral proportions vary even more decidedly,
the following analyses of representative stones are included:
T a b l e 6 . — ESTIMATED

PERCENTAGES OF M INERAL ELEMENTS
MONT GRANITES.
Type of stone.

Dark-blue Hardwick.....................................................................................
Newark granite...............................................................................................
Randolph granite...........................................................................................
Dark Barre granite...........................................................
. . .
Fletcher quarry..............................................................................................
Rochester granite............................................................................................

Quartz.
Per cent.
21. 8
30. 3
21.2
26. 6
31. 2
29.6

OF TYPICAL VER ­

Feldspar.
Per cent.
62.1
64.8
76.5
65. 5
63.1
62.1

Mica.
Per cent.
16.2
4.6
2.3
7.9
5.7
8.3

How far these varying constituent mineral elements of the Vermont
granites bear upon the health-injurious nature of the stone dust in­
haled during cutting and carving processes has not yet been deter­
mined, but it is to be assumed that these and related facts will be
taken account of in the dust investigations by the Bureau of Mines.
The mortality has been ascertained for each plant or working shed
separately, so that a correlation of the technical data will be feasible,
the number employed in each plant being also a matter of record,
together with a full report on plant conditions, both sanitary and
mechanical, including the presence or absence of dust removing or
controlling devices.7
7 It has not been feasible to include the reports on shop conditions within the present discussion as it is
concerned with the mortality rather than the sanitary aspects of the stone industry.




24

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.
SANITARY TOPOGRAPHY OF BARRE DISTRICT* VT.

The following is a brief descriptive account of the Barre district:8
The city of Barre lies about 5 miles southeast of Montpelier, and the Barre quarries
are 3 miles farther southeast, near the southeast corner of the township of Barre, and
a few of them are in Williamstown, in Orange County, which adjoins Barre on the south.
The city of Barre lies on Stephens Brook, a tributary of the Winooski, which empties
into Lake Champlain. About half a mile south-southeast of Barre City this brook
receives a tributary from the southeast known as Jail River. Some
miles south­
east of the city this river flows through a canyon-like gorge between flat-topped masses
of sand, clay, and bowlders over 200 feet thick. A little north of Jail River at this
point a roundish granite mass, known as Cobble Hill, rises to a height of 1,100 feet,
by aneroid, above the city, and 2 miles about southwest of this hill and a little south
of the river another granite mass, known as Millstone Hill, rises to a height of 1,200
feet, by aneroid, above the city. Fifty-six quarries are grouped about these two
granite masses, and of these 52 are about Millstone Hill.

To this are here added extracts relating to the geology of the dis­
trict, useful for comparison with the granite areas of other sections:
Finlay’s map shows that he regards the two granite hills as parts of one granite area
with a north-northeast trend over 4 miles long by 1§ wide, surrounded by elate and
schist. Its representation on the State geologic map of 1861 is not far different. The
writer’s [T. Nelson Dale] time was too short to enable him to trace the boundaries of
the granite and schist, nor was a map suitable for such purpose available. Finlay
represents a schist tongue crossing Millstone Hill diagonally from northwest to south­
east, and Cobble Hill as all granite, but the writer found schist on the north side of
the top of the Cobble, without, however, determining its northern limit. The schist
capping also crops out at Jones Brothers’ and Barclay’s quarries, and near the Marr &
Cordon quarry of the Consolidated Company, and in Websterville.
These are the chief geologic features of the Barre district. Four formations are
represented: (1) The schist, a metamorphosed marine argillaceous and calcareous
sediment of unknown thickness, underlying the city and surrounding the granite
area; (2) the granite, of igneous origin, intruded in the schist and forming two domes,
2 miles apart, with an intervening depression, which in consequence of the erosion of
the schist now project through it; (3) certain dark basic dikes of later date cutting the
granite and the schist also; (4) finally, masses of sand, clay, and bowlders, over 200
feet thick, in the hollow between the domes of glacial origin overlying the schist and
part of the granite.
As many as seven different sets of surface forms have existed here: (1) The original
surface of the sediments of clay and sand before their emergence from the sea; (2)
the surface of those sediments after their metamorphism into schist and before the
granitic intrusion; (3) the surface of the schist mass as modified by the granitic intru­
sion; (4) the surface of the schist and granite masses which resulted from the long
period of preglacial erosion; (5) the original surface of the superimposed glacial
deposits; (6) the surface of the glacial deposits as modified by glacial lake levels; (7)
the surfaces produced in both unmodified and modified glacial deposits by postglacial
streams. It is assumed in this outline that any modifications of the eroded rock sur­
face by the glacier were unimportant, and the surface of the ice sheet itself has not
been considered.

Much valuable information in detail is available through other
sources, particularly the reports of the State geologist of Vermont,
while Bulletin No. 404 of the United States Geological Survey
includes a brief bibliography on the economic geology of granite
useful for more extended research. (See particularly lJay’s report
on Granite Quarrying in Europe; Mineral Resources, 1893; and.the
report of the eleventh census on Methods of Quarrying, Cutting, and
Polishing Granite, Washington, 1892.)
DEATH CERTIFICATES ANALYZED.

The mortality analysis made from original data through the cooper­
ation of the Vermont State Board of Health covers a period of 26
years, limited to the counties of Washington and Caledonia. The
8 The Granites of Vermont, by T. Nelson Dale, Washington, D . C., 1909, p. 47 et seq.




MORTALITY AMONG GRANITE-STONE WORKERS.

25

total number of death certificates examined was 18,406, of which
2,092 were deaths from pulmonary tuberculosis and 166 deaths from
other forms of tuberculosis, or 11.4 and 0.9 per cent, respectively,
of the mortality from all causes.
MORTALITY EXPERIENCE OF THE GRANITE CUTTERS’ INTERNATIONAL
ASSOCIATION.

The mortality analysis of the Granite Cutters’ International Asso­
ciation of America is for the entire United States and Canada, but in
somewhat greater detail for the State of Vermont. For the whole
United States and Canada this experience concerns an exposure in
1917 of 8,274 granite cutters, the highest number of members having
been reported for the year 1906 (10,185) and the lowest for the year
1895 (2,850). The total mortality under observation during the
period 1889-1917 was 3,357, which has been correlated to the adult
male population of New England for the same period, showing a
surprising divergence in the results.
T a ble 7*—M O R T AL IT Y FROM A L L CAUSES AMONG THE GRANITE CUTTERS OT THE
U NITED STATES AND CANADA COMPARED W IT H T H A T OF THE A D U LT MALE PO PU ­
LATION OF N E W EN G L A N D ,1 1889 TO 1917.
[Data forgranite cutters taken from experience ofthe Granite Cutters’ International Association of America.]

Males of New England1 20 years
of age and over.

Granite cutters.
Year.
Number
exposed.
1889...................................................
1890...................................................
1891....................................................
1892...................................................
1893....................................................
1894...................................................
1895....................................................
1896...................................................
1897....................................................
1898...................................................
1899....................................................
1900...................................................
1901....................................................
1902...................................................
1903...................................................
1904...................................................
1905...................................................
1906...................................................
1907....................................................
1908...................................................
1909....................................................
1910...................................................
1911....................................................
1912...................................................
1913...................................................
1914...................................................
1915...................................................
1916...................................................
1917...................................................

3,834
4,949
6,407
4,375
3, 887
3, 399
2, 850
4,116
4,779
4,457
4,471
5,362
6,864
7,760
8,768
8,568
9,148
10,185
9,056
8,810
9,869
9,607
9, 225
8,742
7,797
9,721
9,052
9,739
8,274

Deaths.

45
62
55
70
73
79
57
48
53
76
62
62
71
87
88
118
143
144
138
149
111
179
178
165
206
217
202
206
213

Death rate Population.
per 1,000.
11.7
12.5
8.6
16.0
18.8
23.2
20.0
11.7
11.1
17.1
13.9
11.6
10.3
11.2
10.0
13. 8
15.6
14.1
15.2
16.9
11.2
18.6
19.3
18.9
26.4
22.3
22.3
21.2
25.7

2 989,392
a 1,016,405
a 1,038,240
1,270, 871
1,294, 364
1,317, 857
1, 341, 352
1, 367, 030
1,392, 708
1,418, 386
1,444,065
•1,469, 744
1,488, 842
1, 507, 940
1,527,038
1, 546,137
1, 565, 236
1, 596,379
1,627,522
1,658,665
1,689,808
1, 720, 952
1,748,102
1,775, 252
1, 802, 402
1, 829, 552
1, 856,702
1,883, 852
2 1,656,157

Deaths.

2 17,530
2 18,961
* 19, 532
25,759
25,197
23,910
24,228
24,533
24,318
24, 892
25,589
26,352
26,969
25, 869
27,186
27,649
28,497
27, 855
30,696
28,390
28,783
30, 833
31,367
30, 515
31, 465
31, 725
31,687
34,184
2 29, 731

Death rate
per 1,000.
* 17.7
8 18.6
2 18.8
20.3
19.5
18.1
18.1
17.9
17.5
17.5
17.7
17.9
18.1
17.2
17.8
17.9
18.2
17.4
18.9
17.1
17.0
17.9
17.9
17.2
17.5
17,3
17.1
18.1
*18.0

i Connecticut excepted.
* New Hampshire, Vermont, Massachusetts, and Rhode Island.

A summary of this table for five-year periods clearly illustrates
present-day tendencies and, as regards the stone-cutting industry,
tendencies in the wrong direction.




DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

26

T a b le 8 .—M OR T AL IT Y FROM A L L CAUSES AMONG TH E GRANITE CUTTERS OF T H E
U NITED STATES A N D CANADA, COMPARED W IT H T H A T OF TH E A D U L T M ALE POPU­
LATION OF N E W EN G LAN D , 1889 TO 1917, B Y 5-YEAR PERIODS.
[Data for granite cutters taken from experience of the Granite Cutters International Association of
America.]

Males of New England 20 years of age and
over.

. Granite cutters.
Period.
Number
exposed.

Deaths.

26,851
20,673
37,322
47, 068
45,092
27,065

384
296
426
685
945
621

1889-1894..................
1895-1899..................
1900-1904..................
1905-1909..................
1910-1914..................
1915-1917..................

Relative
Death
number Aggregate Deaths.
rate per (1889-1894
population.
1,000.
= 100).
14.3
14.3
11.4
14.6
21.0
22.9

100.0
100.0
79.7
102.1
146.8
160.1

6,927,129
6,963, 541
7,539, 701
8,137,610
8,876,260
5,396, 711

Relative
Death
rate per number
1,000. (1889-1894
- 100).

130,889
123,560
134,025
144,221
155,905
95, 602

18.9
17.7
17.8
17.7
17.6
17.7

100.0
93.7
94.2
93.7
93.1
93.7

The death rate from all causes of granite cutters has increased from
11.7 per 1,000 in 1889 to 25.7 in 1917, while during the corresponding
period the adult male death rate of the New England States has
declined from 20.3 in 1892 to 18.0 in 1917. Since so many factors
enter into the total mortality experience of the Granite Cutters'
Association, it has seemed best to limit the more detailed comparison
of tuberculosis frequency to well-defined areas, beginning, however,
with the State of Vermont.
9 .—M O R T AL IT Y FROM PULM ONAR Y TUBERCULOSIS AMONG THE GRAN ITE
CUTTERS OF VER M O NT, COMPARED W IT H T H A T OF THE G EN ER A L AD U L T POPU­
LATION OF THE STATE, 1898 TO 1918.

T a b le

[Data for granite cutters taken from experience of the Granite Cutters’ International Association of
America.]
General population (20 years of age
and over).

Granite cutters.
Year.
Number
exposed.

1896...................................................
1897...................................................
1898...................................................
1899....................................................
1900...................................................
1901....................................................
1902...................................................
1903...................................................
1904...................................................
1905...................................................
1906....................................................
1907...................................................
1908...................................................
1909...................................................
1910...................................................
1911...................................................
1912...................................................
1913....................................................
1914....................................................
1915....................................................
1916....................................................
1917...................................................
1918 1

1,164
1,262
1,491
1,667
1,843
1,860
2,198
2,342
2,504
2,595
2,938
3,046
2,881
3,134
3,296
3,352
3,266
3,660
3,529
3,613
3,233
2,921
2,727

1 Exclusive of last three months of 1918.




Deaths.

3
5
6
8
5
5
9
8
11
20
19
25
22
19
27
25
19
28
38
32
43
32
26

Death
rate per
100,000.
257.7
396.2
402.4
479.9
271.3
268.8
409.5
341.6
439.3
770.7
646.7
820.7
763.6
606.2
819.2
745.8
581.8
765.0
1,076. 8
885. 7
1,330. 0
1,095. 5
953.4

Population.

214,008
215,081
216,153
217,226
218, 298
219,120
219,942
220, 763
221,585
222,407
223,229
224,051
224, 872
225,694
226, 516
227,338
228,160
228,981
229,803
230,625
231,447
232,269

Deaths.

444
348
380
464
399
391
358
329
344
369
334
323
338
305
281
300
238
289
262
231
297
224

Death
rate per
100,000.
207.5
161.8
175.8
213.6
182.8
178.4
162.8
149.0
155.2
165.9
149.7
144.2
150.3
135.1
124.0
132.0
104.3
126.2
114.0
100.2
128.3
96.4

MORTALITY AMONG GRANITE-STONE WORKERS.

27

A summary of the data in the foregoing table follows:
10 .—M O R T AL IT Y FROM PU LM O N AR Y TUBERCULOSIS AMONG GR AN ITE CUT­
TERS. COM PARED W IT H T H A T OF THE G EN ER AL A D U L T POPULATION OF V E R ­
MONT, 1896 TO 1918, B Y 5-Y E A R PERIODS.
[Data for granite cutters taken from experience of the Granite Cutters’ International Association.]

T a b le

Granite cutters.
Period.

Number
exposed.

Deaths.

5,584
10,747
14,594
17,103
12,494

22
38
105
137
133

1896-1899...................
1900-1904...................
}905r-1909...................
1910-1914...................
1915-19181................

Relative
Death
rate per number
100,000. (1896-1899
= 100).
394.0
100. 0
353.6
89.7
719. 5
182.6
801.0
203.3
1,064. 5
270.2

General adult population (20 years of age
and over).
Relative
Death
Aggregate
number
population. Deaths. rate per (1896-1899
100,000.
-100).
1,636
100. 0
189.7
862,468
1,821
165.6
1,099,708
87.3
149.0
1,669
1,120,253
78. 5
120.1
1,370
1,140,798
63. 3
752
* 108. 3
57.1
694,341

i Exclusive of last three months of 1918.

* 1915-1917.

During the period under observation the mortality from pulmonary
tuberculosis among granite cutters increased from a rate of 257.7 per
100,000 in 1896 to 953.4 in 1918 (a maximum figure of 1330.0 having
been reached in 1916), while the corresponding mortality of the gen­
eral adult population declined from a rate of 207.5 in 1896 to 96.4 in
1917, excluding in the case of granite cutters the last three months of
1918 on account of the influenza epidemic.
COMPARATIVE NEW ENGLAND MORTALITY DATA.

The results of this comparison are quite similar to one for the gran­
ite cutters of the State of Massachusetts, as shown by Table 11.
The pulmonary tuberculosis death rate of the adult male population
of the State diminished from 295.0 per 100,000 in 1896 to 209.2 in
1917, whereas the corresponding mortality of the granite cutters of
this State increased from 410.2 in 1897 to 1056.3 in 1918. A maxi­
mum death rate of 1250.0 was reached in 1916.
11 .—M O R T A L IT Y FROM PU L M O N AR Y TUBERCULOSIS AMONG T H E G R AN ITE
CUTTERS OF MASSACHUSETTS COMPARED W IT H T H A T OF TH E G E N E R A L A D U L T
POPULATION OF TH E STATE, 1896 TO 1918.
rData for granite cutters taken from experience of the Granite Cutters’ International Association of America.]
T a b le

Granite cutters.
Year or period.

Male population (20 years of General population (20 years
age and over).
of age and over).
Death
Death
Population. Deaths. rate per Population. Deaths.- rate per
100,000.
100,000.
2, 334
1,649, 279
295.0
4,648
791,091
281. 8
2, 282
1,686,922
810,369
281.6
4,571
271.0
1,724, 565
2,373
4,482
286.0
829,647
259.9
1,762, 208
848,925
2,382
280.6
4,461
253.1
1,799, 851
868, 201
2,298
264.7
4,426
245.9
880, 578
2,308
262.1
1, 827, 738
4, 347
237.6
1,855,625
892,955
2,141
239.8
4,040
217.7
1,883, 512
905,332
2,022
223.3
3, 857
204.8
2, 211
1,911, 399
240.9
4,187
219.0
917, 709
1,939, 287
4, 081
930,088
2,195
236.0
210.4
1,983,662
954, 510
2,156
225.9
3,948
199.0
2,028, 037
4,152
978,932
2, 336
238.6
204.7
2,072,412
3, 883
1,003, 354
2,207
220.0
187.4
2,116,787
3, 852
2,127
207.0
1,027,776
182.0
2,161,163
3,978
184.1
1,052,198
2, 252
214.0
2,199, 045
3, 887
1,072,627
2, 233
208.2
176.8
2,236,927
3,713
1,093,056
2,128
194.7
166.0
2,274, 809
199.3
3,670
161.3
1,113, 485
2,220
2,312,691
3,716
2,275
200.6
1,133,914
160.7
2,350, 571
3,693
157.1
1,154,343
2,201
190.7
2,388,453
3,998
209.4
1,174,772
2,460
167.4
2,426,335
4,086
168.4
209.2
2,500
1,195,201

Death
Num­
ber ex­ Deaths. rate per
100,000.
posed.
1896.........................
991
410.2
1897.........................
975
4
1898........................
6
621.1
966
1899........................
9
899.1
1,001
1900.........................
4
1,194
335.0
1901.........................
9
688.6
1,307
1902.........................
12
786.9
1, 525
1903.........................
8
490.6
1,630
1904.........................
1,732
7
404.2
1905.........................
8
412.2
1,941
1906......................... 2,279
11
482.7
1907......................... 2,067
10
483.8
1908......................... 1,952
15
768.4
1909......................... 2,028
9
443.8
1910........................
14
739.2
1,894
1911........................
14
2,041
685.9
1912........................
20 1,058.2
1,890
1913........................
22 1,204.8
1,826
1914........................
20 1,122.3
1,782
1915.........................
13
1,792
725.4
1916.........................
1,840
23 1,250.0
1917......................... 1,804
16
886.9
21 1,056.3
19181 .
1,988
3,280,032
9,371
1896-1899...............
19
3,933
483.1
4,464,775 10,980
1900-1904...............
7,388
40
541.4
516.2
4,894,660 11,021
1905-1909............... 10,267
53
5,465,280 11,108
1910-1914...............
954.0
9,433
90
983.3 3 3, 524,316 a 7,161
73
1915-19181.............
7,424
i Exclusive of last three months of 1918.

61928°— 22— Bull. 293------ 3




285.7
245.9
225.2
203.2
8 203.2

6, 822,974 18,162
9,278,125 20,857
10,140,185 19,916
11,184,635 18,964
2 7,165,359 *11,777
* 1915-1917.

. 266.2
224.8
196.4
169.6
2 164. 4

28

DUST PH TH ISIS IK THE GRANITE-STONE INDUSTEY.

Table 12 shows the corresponding data for Maine and New Hamp­
shire and for the New England States combined.
1 2 .—M O R T A L IT Y FROM P U L M O N A R Y TUBERCULOSIS AMONG T H E G R ANITE
CUTTERS OF M AINE AND N E W H AM PSH IR E AND OF TH E N E W E N G LAN D STATES
COMPARED W IT H T H A T OF TH E G EN ER AL AD U L T PO PU LATIO N OF TH E SAME
STATES, 1896 TO 19-18.

T a b le

[Data for granite cutters taken from experience of the Granite Cutters’ International Association of
America.]

MAINE AND NEW HAMPSHIRE.
General population (20 years of age
and over).

Granite cutters.
Year or period.
Number
exposed.
1896.................... . .............................
1887...................................................
1898...................................................
1809...................................................
I960. ................................................
1901...................................................
19®......... .........................................
1903...................................................
1904...................................................
1905...................................................
1906...................................................
1907...................................................
1908...................................................
1909...................................................
1910...................................................
1911.. . ..........................................
1912...................................................
1013......................... . .......................
1914...................................................
1915...................................................
1916...................................................
1917...................................................
1918 i.................................................

1,033
1,054
979
894
1,224
1,627
1,887
1,556
1,896
1,864
1,951
1,718
1,809
1,930
1,968
1,798
1,609
1,375
1,557
1,382
1,317
1,257
1,187

1896-1899..........................................
1900-1904.......................................
1905-1909..........................................
1910-1914..........................................
1915-1918 1........................................

3,960
8,190
9,272
8,307
5,143

Deaths.

Death rate Population.
per 100,000.

5
3

Deaths.

Death rate
per 100,000.

5
7
4
8
9
11
13
11
7
13
5
15
§
9
19
11
9
13
18
17

484.0
284.6
408.6
559.2
571.9
245.8
423.9
578.4
580.2
697.4
563.8
407.4
718.6
259.1
762.2
500.5
559.9
1,381.6
706.5
651.2
987.0
1,432.0
1,432. 2

692,379
697,517
702,656
707,794
712,934
717,051
721,169
725,287
729,404
733,521
737,639
741,757
745,874
749,991
754,110
758,228
762,345
766,462
770,580
774,698
778,815
782,932

1,526
1,533
1,373
1,371
1,404
1,414
1,305
1,220
1,369
1,236
1,210
1,210
1,171
1,110
1,201
1,111
1,015
1,023
999
1,039
1,005
967

220.4
219. 8
195.4
193.7
196. &
197.2
181.5
168.2
187.7
168.5
164.0
163.1
157.0
148.0
159.3
146.5
133.1
133,5
129.6
134.1
129.0
123.5

17
39
49
63
57

429.3
476.2
528. 5
758.4
1,108.3

2,800,346
3,605,845
3,708,782
3,811,725
2 2,336,445

5,803
6,712
5,937
5,349
a 3,011

207.2
186.1
160.1
14a 3
* 128.9

3,337,474
3,397,264
3,457,056
3,516,846
3,576,638
3,628,786
3,680,935
3,733,083
3,785,232
3,837,381
3,907,419
3,977,457
4,047,494
4,117,530
4,187,571
4,250, 416
4,313,259
4,376,102
4,438,947
4,501,789
4,564,633
4,627, 477

8,373
8,221
8,139
8,234
8,248
8,121
7,547
7,294
7,751
7,653
7,353
7,715
7,329
7,193
7,427
7,234
6,792
6,865
6,948
6,925
7,367
7,472

250.9
242.0
235.4
234.1
230.6
223, 8
205.0
195.4
204.8
199.1
188.2
194.0
181.1
174.7
177.4
170.2
157.5
156.9
156.5
153.8
161.4
161.5

432.0 13,708, <>40
453.7 18,404,674
611.6 19,887,281
802.2 21,566,295
1,044.3 213,693,899

32,967
38,961
37,243
35,266
* 21,764

240.5
211.7
187.3
163.5
*158.9

4

ITEW EN&LAND STATES.
1896......... „........................................
1897......„...........................................
1898...................................................
1899....................................................
1900....................................................
1901...................................................
1902...................................................
1903...................................................
1904...................................................
1905...................................................
1906...................................................
1907...................................................
1908...................................................
1909....................................................
1910...................................................
1911...................................................
1912...................................................
1913.......................................... . .......
1914....................................................
1915...................................................
1916...................................................
1917....................................................
19181........................................ .........

3,747
3,918
4,046
4,029
4,758
5,300
6,166
6,251
6,842
7,202
8,049
7,569
7,316
7,798
7,888
7,937
7,609
7,767
7,567
7,453
7,051
6,662
6,605

10
15
17
26
20
20
30
31
32
43
49
46
56
38
59
54
49
74
75
61
84
72
73

1896-1899..........................................
1900-1904..........................................
19O6“ 1909..........................................
1 9 1 0 -19 1 4 .................... ...............
1915-1918 1........................................

15,740
29,317
37,934
38,768
27,771

68
133
232
311
290

* Exclusive of last three months of 1918.




266.9
382.8
420.2
645.3
420.3
377.4
486. 5
495.9
467.7
597.1
608.8
607.7
765.4
487.3
748.0
680.4
644.0
952.7
991.1
818.5
1,191.3
1,08a 8
1,105.2

* 1915-1917.

29

MORTALITY AMONG GRANITE-STONE WORKERS.

This table is s elf-explana tory and requires b o extended considera­
tion, ao?r kas ^ seemed necessary to correlate similar tables for other
stone centers of the United States, but the facta as summarized in
Table 13, which gives the death rates of granite cutters for a 23-year
period, as based upon the experience of the Granite Cutters’ Inter­
national Association of America, show that, without exception, there
was a persistent increase in the rates during the entire period. The
districts which exhibit the highest prevailing rates at the present time
are Vinal Haven, Hurricane Island, and Mount Waldo, Me.; Hallowell, North Jay, and Portland, Me. ; Barre, Vt., and Montpelier, Vt.
Lower rates are shown for the granite-cutting districts of the South­
ern, the Pacific Coast, and the Southwestern States, where, no doubt,
much, if not all, of the work of cutting and carving is done outside
or in open sheds.
dPkBLE 1 3 .—M O R T A L IT Y FROM P U L M O N A R Y TUBERCULOSIS AMONG G R AN ITE CUT­
LERS OF THE PRINCIPAL GRANITE-CUTTING CENTERS, 1898 TO 1918, B Y PERIODS
OF YE A R S.
[Experience of the Granite Cutters^ International Association of America.]

Place and period.

Vinal Haven, Hur­
ricane Island, and
Mount Waldo, Me.:
1896-1903.............
1904-1911.............
1912-19181...........
Hallo well,
North
Jay, and Portland,
Ma •
1896-1903.............
1904-1911.............
1912-19181...........
Concord and Mil­
ford, N. H .:
1896-1903.............
1904-1911.............
1912-19181...........
Barre, V t.:
1896-1903.............
1 9 0 4 -m i.............
1912-19181...........
Montpelier, V t.:
1898-1903.............
1904-1911.............
1912-19181...........
Quincy and West
Quincy, Mass.:
1896-1903.............
1904-1911.............
1912-19181...........

Number
exposed. Deaths.

Death
rate per
100,000.

2,126
2r842
884

15
25
15

705.6
879.7
1,696. 8

2,448
2,366
1,624

12
26
25

490.2
1,103,6
1,539.4

1,941
2, 806
3,044

8
12
26

412.2
427. 7
854.1

8,70S
12,579
12*141

36
118
145

413.4
938.1
1,194.3

1,723
31,282
2,918

6
21
30

348.2
643.8
1,028.1

4,821
6,811
6,101

25
37
50

518.6
543.2
819.5

Place and period.

Boston, Worcester,
and Cape Ann,
Mass.:
1896-1903.............
1904-1911.............
1912-19181............
Providence
and
Westerly, R. I.,
and Stony Creek,
Conn.:
1896-190S............
1904r-1911.............
1912-19181...........
Albany and New
York, N. Y .:
1896-1903.............
1904-1911.............
1012-19181...........
Buffalo, Cleveland,
Detroit, and Chi­
cago:
1896-1903-.............
1904-1911.............
1912-19181...........
Philadelphia, Pa.:
1896-1903.............
1904-1911.............
19-12-19181...........

Number Deaths.
exposed.

Death
rate per
100,000.

1,585
3,582
2,601

7
16
22

441.6
446.7
845.8

2,838
3,484
3,630

17
23
33

599.0
660.2
909.1

3,731
3,921
4,349

23
31
41

616.4
790.6
942.7

714
1,373
1,796

1
12
m

140.1
873.9
890.9

1,620
2,061
1,547

7
15
12

432.1
727.8
775.7

1 Exclusive of influenza-epidemic period.

VALUE OF PROPORTIONATE MORTALITY FIGURES.

The proportionate mortality figures for tuberculosis have not
undergone a corresponding change. No satisfactory explanation
can be made of this phenomenon without an extended statistical
analysis, which for the present purpose would seem not to be called
for. For all ages the percentage the deaths from pulmonary tuber­
culosis are of the mortality from all causes is 44.6 for the period
1906—1918. The proportionate mortality figures are extraordinarily
high at ages 25 to 64, for which years nearly one-half of the entire




30

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

mortality is due to pulmonary tuberculosis alone. The facts, in
detail, are given in Table 14, for the entire United States and Canada,
for the State of Vermont alone, and for other sections of the country.
T a b l e 1 4 . — PR OPOR TIONATE

M O R T A L IT Y FROM PU LM O N AR Y TUBERCULOSIS AMONG
GRANITE CUTTERS, 190S TO 1918, B Y AGE GROUP AN D PERIO D OF Y E A R S.
[Experience of Granite Cutters' International Association of America.]
U N IT ED ST A T E S AN D C A N A D A .

1906-1912.

1913-1918.1

Deaths from
pulmonary
tuberculosis.
Age at death.

Deaths
from all
causes.

Num­
ber.

1906-1918.1

Deaths from
pulmonary
tuberculosis.

Deaths
from all
Per
cent of causes.
Num­
deaths
from
ber.
all
causes.

Deaths from
pulmonary
tuberculosis.

Deaths
Per from all
cent of causes.
deaths
from
all
causes.

Num­
ber.

Per
cent of
deaths
from
all
causes.

20 to 24 years............................
25 to 29 years............................
30 to 34 years............................
35 to 39 years............................
40 to 44 years............................
45 to 49 years............................
50 to 54 years............................
55 to 59 years............................
60 to 64 years............................
65 to 69 years............................
70 to 74 years............................
75 to 79 years............................
80 years and over

35
57
72
122
152
136
149
116
96
64
27
14
10

7
30
34
56
75
75
78
42
33
15
4

20.0
52.6
47.2
45.9
49.4
55.2
52.4
36.2
34.4
23.4
14.8

11
34
63
107
152
183
194
131
127
95
45
17
12

2
13
31
52
94
103
92
64
55
25
10
1

18.2
38.3
49.2
48.6
61.8
56.3
47.4
48.9
43.3
26.3
22.2
5.9

46
91
135
229
304
319
343
247
223
159
72
31
22

9
43
65
108
169
178
170
106
88
40
14
1

19.6
47.3
48.2
47.2
55.J5
55.8
49.6
42.9
39.5
25.2
19.4
3.2

Total...................................

1,050

449

42.8

1,171

542

46.3

2,221

991

44.6

VERM ONT.
1
20 to 24 years........
25 to 29 years........
30 to 34 years........
35 to 39 years........
40 to 44 years........
45 to 49 years........
50 to 54 years........
55 to 59 years........
60 to 64 years........
65 to 69 years........
70 to 74 years........
75 to 79 years........
80 years'and over.

12
23
21
45
51
41
41
24
13
5
2
1

4
15
8
25
27
24
30
11
8
1

33.3
65.2
38.1
55.6
52.9
58.5
73.2
45.8
61.5
20.0

2
16
20
43
63
71
50
39
17
10
3

11
12
23
40
51
29
23
6
3

68.8
60.0
53.5
63.5
71.8
58.0
59.0
35.3
30.0

14
39
41
88
114
112
91
63
30
15
5
1

4
26
20
48
67
75
59
34
14
4

28.6
66.7
48.8
54.5
58.8
67.0
64.8
54.0
46.7
26.7

Total...............

279

153

54.8

334

198

59.3

613

351

57.3

M ASSACH U SE TTS, CONNECTICUT, AND RHODE ISLA N D .
20 to 24 years.......
25 to 29 years.......
30 to 34 years.......
35 to 39 years____
40 to 44 years____
45 to 49 years____
50 to 54 years-----55 to 59 years-----60 to 64 years____
65 to 69 years____
70 to 74 years___
75 to 79 years____
80 years and over
Total.............

3
14
11
38
28
38
37
43
30
33
14
3
5

1
7
6
13
15
21
13
18
11
7
4

33.3
50.0
54.5
34.2
53.6
55.3
35.1
41.9
36.7
21. 2
28.5

1
6
18
19
23
42
53
41
42
40
22
6
5

2
8
10
17
23
24
21
18
10
5

33.3
44.4
52.6
73.9
54.8
45.3
51.2
42.8
25.0
22.7

4
20
29
57
51
80
90
84
72
73
36
9
10

1
9
14
23
32
44
37
39
29
17
9

25.0
45.0
48.3
40.4
62.7
55.0
41.1
46.4
40.3
23.3
25.0

297

116

39.1

318

138

43.4

615

254

41.3

1 Exclusive of last quarter of 1918.




31

MORTALITY AMONG GRANITE-STONE WORKERS.
T a b l e 1 4 . — PROPO RTIONATE

M O R T A L IT Y FROM PU LM O N AR Y TUBERCULOSIS AMONG
GRANITE CUTTERS, 1906 TO 1918, B Y AGE AND GROUP PERIOD OF Y E A R S—Con.
M A IN E A N D N E W H A M P S H IR E .
1906-1912

1913-1918

Deaths from
pulmonary
tuberculosis.
Age at death.

Deaths
from all
causes.
Num­
ber.

20 to 24 years___
25 to 29 years___
30 to 34 years___
35 to 39 years___
40 to 44 years___
45 to 49 years___
50 to 54 years___
55 to 59 years___
60 to 64 years___
65 to 69 years___
70 to 74 years___
75 to 79 years___
80 years and over
Total.............

1906-1918

Deaths from
pulmonary
tuberculosis.

Deaths
Per
from all
cent of causes.
Num­
deaths
from
ber.
all
causes.

Deaths from
pulmonary
tuberculosis.

Deaths
from all
Per
cent of causes.
Num­
deaths
from
ber.
all
causes.

25.0
50.0
76.9
50.0
54.5
57.9
49.1
37.5
48.6
41.7
28.6

100.0

57.1
75.0
40.0
52.6
61.9
41.7
25.0
42. 1
33.3
16.6

Per
cent of
deaths
from
all
causes.

80.0
62.5
57.1
52.9
54.5
50.0
55. 6
50.0
37.5

139

47.6

On the whole there is a remarkable consistency, confirming the
mortality figures based on the exposure to risk and exhibiting the
highest proportionate death rates for the State of Vermont, where,
for the period 1906-1918, 57.3 per cent of the deaths from all causes
were due to pulmonary tuberculosis alone. The highest propor­
tionate mortality figures occurred at ages 45 to 49, being 67.0 per
cent of the deaths from all causes. For Massachusetts, Connecticut,
and Rhode Island the corresponding proportion—for ages 40 to 44
years—was 62.7, which would seem not to require additional evidence
to sustain the conclusion, previously advanced, that the present
mortality problems of the stone industry are such as to call most
urgently for qualified public consideration.
OCCUPATIONAL MORTALITY IN THE GRANITE INDUSTRY.

In the foregoing observations the mortality experience of the
Granite Cutters’ International Association of America has been
considered without reference to particular employments. In Table
15, however, an analysis is presented of the principal occupations,
and, while the facts for other employments than cutting are rela­
tively limited, *they are entirely conclusive. Taking the period of
1905-1918 as a convenient basis of comparison, it is shown by
Table 15 that the death rate of granite cutters in the districts of
Barre, Vt., and Quincy, Mass., combined was 949.6 per 100,000, in
contrast to a rate of 339.4 for tool sharpeners, 254.4 for lumpers,
boxers, and derrick men, and 187.6 for polishers. These results
strikingly confirm the conclusions, based upon general observations,
that the excess in the death rate bears primarily, if not exclusively,
upon the granite cutters and carvers, or those who make use of
pneumatic tools.




DUST P H TH ISIS IN THE GRANITE-STONE INDUSTRY.
1 5 .—M O R T AL IT Y FROM PU LM O N AR Y TUBERCULOSIS AMONG T H E G R ANITE
CUTTERS OF B A R R E , V T ., AN D QUINCY, MASS., COMPARED W IT H T H A T OF TOOL
SHARPENER S, LUMPERS, B O X E R S, D ER R ICK MEN, AN D GRANITE POLISHERS, 1896
to 1918.
Granite cutters.1
Year or
period.

Tool sharpeners.2

Lumpers, boxers,3
and derrick men.

Granite polishers.1

Death Num­
Death Num­
Death
Death Num­
Num­
ber
ber Deaths. rate
rate
ber Deaths. rate
ber Deaths. rate
exex- Deaths. per
exper
per
ex­
per
100,000.
100,000.
100, 000.
posed.
100 000

, .

190 3
190 4
190 5
1006...........
*907...........
190 8
190 9
191 0
*911...........
1012...........
191 3
191 4
191 5
191 6
191 7
191-84.........

1,339
1,325
1,5-70
1,679
1,887
1,836
1.931
1,962
1.932
2,252
2,309
2,563
2,487
2, 574
2.555
2,718
2,562
2,605
2,666
2,885
2,677
2,482
2,365

1896-1899..
1900-1904..
1905-1909..
1910-1914..
1915-19184
1905-1918f

5,913
9, 548
12,185
13,106
10,409
35, 700

1899...........
I960...........
1901...........

im .......

7
6
7
10
12
10
11

19

17
18
24
16
27
23
20
25
31
30
35
28
26

224. 0
452.8
445. 8
357.4
371.0
544.7
621.4
509. 7
569.4
843.6
736.2
702.3
965.0
621.6
1.056.8
845.2
780.6
959.7
1.162.8
1, 039.9
1.307.4
1,128.1
1.099.4

108

122

148
147
98
190
189
192
224
244
263
301
292
284
278
239
231
235
210
183
169
162
150

372.1
22
52.5
50
523.7
893
771.4 1,384
94
961.4 1,193
126
119 1,143.2
664
949.6 3,241
339

1 Barre, Vt., and Quincy, Mass.
2 Quincy, Mass., Westerly, R. I., Barre and Hardwick, Vt.

289
314
344
312
280
281
294

106
126
197
219
195
194
232
250
257
273
272
298
295
284

1,315
1,449
1,167
3,931

843
1,206
1,149
254.4 3> 198

229
246
263
281
296
291
211

187.6

3 Barre, Vt.
* Exclusive of last three mcnths of 1918.

Similar results have been observed elsewhere. In Table 16 the
mortality from pulmonary tuberculosis among the granite workers of
the Barre and Quincy districts is compared with the corresponding
mortality in the Derbyshire district of England, reported upon by
Dr. Sidney Barwise in a notable report on the Prevalence of Phthisis
Among Quarry Workers and Miners to the Derbyshire County
Council, February 6, 1913.
1 8.—M O R T A L IT Y FROM PU L M O N AR Y TUBERCULOSIS AMONG T H E G R AN ITE
W O R K E R S OF B A R R E , V T .. A N D QUIN CY, MASS., COM PARED W IT H T H A T AMONG
SPECIFIED STONE W O R K E R S, COAL MINERS, AND AG RICU LTU RISTS IN D E R B Y ­
SHIRE COU N TY, E N G L A N D .

T a b le

BA R R E , V T ., AND QTTINCY, M ASS.—19Q5-1918.1
Occupation.
Standard pulmonary tuberculosis dasth tate *........................ ...............................
Grafnite cutters............... .................... ...............................................................................
Tool sharpeners......................................................................................................................
Lumpers, boxers, and derrick men..................................................................................
Granite polishers....................................................................................................................

Death rate per
100,000.

173.8
949.6
339.4
254.4
187.6

DERBYSHIRE COUNTY, ENGLAND—1901-1910.
Standard phthisis death rate3. ...........................................................................
Gritstone workers............ . . . . ......................................................................................
The two Matlocks and the two Barleys, stone workers (some in limestone).
Bake well registration district, gritstone and limestone works........................
Persons employed in and about limestone quarries and works.......................
Limestone workers....................................................................................... .............
Persons employed in and about eoal mines..........................................................
Persona employed in agriculture..............................................................................

77. d
1,370.0
700.0
500.0
171.0
152.0

68.0
66.0

1 Exclusive of inffuenza-epidemic period.
* General population of Vermont and Massachusetts (20 years of age and over).
* The phthisis rate for England and Wales is below the American rate because of the high mortality
from acute and chronic bronchitis, which is eight to ten times more common than in this country.




33

MORTALITY AMONG GRANITE-STONE WORKERS.

MORTALITY FROM ALL CAUSES.

To facilitate a broader study of the subject, but without enlarging
unduly upon matters of detail, Table 17 is included to illustrate the
mortality from various causes, limited to the granite cutters of New
England, as compared with the male population of Massachusetts,
20 to 69 years of age, inclusive.
1 7 .—M O R TALITY FROM SPECIFIED CAUSES (ABR ID G ED IN T E R N A TIO N A L
LIST) AMONG THE GRANITE CUTTERS OF N E W ENGLAND COMPARED W IT H
T H A T OF THE M ALE POPULATION OF MASSACHUSETTS, 20 TO 69 Y E A R S OF AG E ,
1913 TO 1917.

T a b le

Males of Massa­
Granite cutters of chusetts, 20 to 69
New England.
years of age.

Abridged
interna­
tional list
number.1

Caus© of death.
Death Num­ Death
Num­
ber of rate per ber of rate per
deaths. 100,000. deaths. 100,000.
541

9.8
.2
.2

2.7
2.7

10
9
16
35

8.2

53
240

1,002.7
8.2
8.2
63.0
5.5
41.1
175.3
24.6
19.2
161.6

409
11,533
165
529
4,875
155
4,229
9,226
87
265
5,963

7.4
208.4
3.0
9.6
88.1
2.8
76.4
166.7
1.6
4.8
107.8

63.0

1,740
717

16.4

688

19.2
54.8
197.3
11.0

488
871
6,031
36
6,777
1,628
13,470
272

31.4
13.0
12.4
8.8
15.7
109.0
.6
122.5
29.4
243.4
4.9

2 19.4

71,060

12.:

Typhoid fever.
Typhus fever..
Malaria.............
Smallpox.........
Scarlet fever................................................................................
Whooping cough........................................................................
Diphtheria and croup...............................................................
Influenza......................................................................................
Asiatic cholera.......................................................................
Cholera nostras - .........................................................................
Other epidemic diseases............................................................
Tuberculosis of the lungs.........................................................
Tuberculous meningitis...........................................................
Other forms of tuberculosis.....................................................
Cancer and other malignant tumors......................................
Simple meningitis......................................................................
Cerebral hemorrhage and softening.......................................
Organic diseases of the heart...................................................
Acute bronchitis.........................................................................
Chronic bronchitis......................................................................
Pneumonia.................................................................................
Other diseases of the respiratory system (tuberculosis ex­
cepted) ......................................................................................
Diseases of the stomach (cancer excepted)..........................
Appendicitis and typhlitis.......................................................
Hernia, intestinal obstruction.................................................
Cirrhosis of the liver.................................................................
Acute nephritis and Bright’s disease.....................................
Senility........................................................................................
Violent deaths (suicide excepted)..........................................
Suicide..........................................................................................
Other defined diseases..............................................................
Diseases ill defined or unknown.............................................
All causes.

.6

1

1.0
4.3

1

54.8

710

1 Manual of the International List of Causes of Death, United States Bureau of the Census, Washing­
ton, D. C., 1916.
* Death rate per 1,000.

Table 18 illustrates the mortality changes in the accumulated
experience of the Granite Cutters’ International Association of Amer­
ica, but limited to the New England States, and the principal causes
of death, emphasizing an increasing death rate not only from pul­
monary tuberculosis but also from pneumonia, bronchitis, asthma,
heart disease, and cancer. It also shows the comparative death rate
for the Massachusetts adult population, indicating throughout for
tubercular and respiratory diseases a diminishing mortality, in
contrast to an increasing death rate among the granite cutters of the
New England States. This table, clearly sustains the conclusion




34

DUST PHTH ISIS IN THE GRANITE-STONE INDUSTRY.

th a t the factors w hich m ake, for a low er resp irato ry m o rta lity am ong
th e general population are offset b y the d ecidedly h ealth -in ju rio u s
conditions affecting the lives of persons em ployed in the g ran itecu ttin g in d u stry.
T a b le 1 8 .—M O R TALITY FROM SPECIFIED CAUSES AMONG TH E G R ANITE CUTTERS
OF N E W ENGLAN D COMPARED W IT H T H A T OF TH E M ALE PO PULATION OF MASSA­
CHUSETTS, 20 TO 69 Y E A R S OF AGE, 1896 TO 1918, B Y PERIOD.

Granite cutters of
New England.

Male population of Mas­
sachusetts, 20 to 69
years of age.

Period.
Number of j Death rate Number of Death rate
deaths.
per 100,000.
deaths.
per 100,000.
Tuberculosis of the lungs.
1896-1899.....................................................................................
1900-1904.....................................................................................
1905-1909.....................................................................................
1910-1914.....................................................................................
1915-19182...................................................................................

68
133
232
311
290

432.0
453.7
611.6
802.2
1,044.3
Pneumonia.

1896-1899.
1900-1904.
1905-1909.
1910-1914.
1915-19182

12
29
32
49
56

76.2
98.9
84.4
126.4
201.6
Bronchitis.

1896-1899.
1900-1904.
1905-1909.
1910-1914.
1915-19182

3
3
7
13
12

1896-1899.
1900-1904.
1905-1909.
1910-1914.
1915-19182

1
5
3
10
7

6. 4
17.1
7.9
25.8
25.2

(92)1

5,568
5, 570
5,870
3,805

6
23
56
59
55

38.1
78.5
147.6
152.2
198.0

130.1
117.6
111.1
3 112.6

(89, 90)1

718
570
467
187

16.8
12.0
8.8
3 5.5

332
233
113
64

7.8
4.9
2.1
3 1.9

(96)i

Organic diseases of the heart.
1896-1899.
1900-1904.
1905-1909.
1910-1914.
1915-19182

247.4
225.0
204.5
3 207.0

10,592
10,653
10,805
2 6,997

19.1
10.2
18.5
33.5
43.2
Asthma.

(28)*

(79)1

5,979
6,609
7,128
5,894

Cancer and other malignant tumors.
1896-1899.
1900-1904.
1905-1909.
1910-1914.
1915-19182

3
4
11
24
17

19.1
13.6
29.0
61.9
61.2

2,629
3,348
4,141
3,057

139.7
139.6
134.9
s 174.4
(39-45)1

61.4
70.7
78.4
90.4

1 The numbers in parentheses refer to the international list numbers. See Manual of the International
List of Causes of Death, United States Bureau of the Census, Washington, D. C., 1916.
8 Exclusive of influenza-epidemic period.
• 1915-1917.




MORTALITY AMONG GRANITE-STONE WORKERS.

35

MORTALITY BY SINGLE YEARS OF LIFE.

To make the foregoing analysis as complete as possible Table 19
has been included, which exhibits the mortality among the granite
cutters by single years of life from pulmonary tuberculosis, from
nontuberculous respiratory diseases, from all other causes, and from all
causes combined. According to this table the maximum age attained in
a total of 2,221 deaths was 87 years. The average age at death from
pulmonary tuberculosis was 47.4 years, from nontuberculous respira­
tory diseases 51.9 years, from all other causes 50.9 years, and from all
causes combined, 49.5 years. The corresponding average ages at death
of the adult white male population of the United States registration
area were 41 years for pulmonary tuberculosis, 57.5 years for tubercu­
lous respiratory diseases, 58.9 years for all other causes, and 56.6 years
for all causes combined. It is therefore shown that death from puljnonary tuberculosis among granite cutters occurs on the average about
six years later than among the normal male population, while from
all causes combined granite cutters die about seven years earlier.
T a b le 1 9 .—M O RTALITY FROM PU LM ONAR Y TUBERCULOSIS, NONTUBERCULOUS
R ESPIR AT O R Y DISEASES, AN D A L L CAUSES AMONG TH E GRANITE CUTTERS OF
T H E UN ITED STATES AN D CAN AD A, 1906 TO 1918,i B Y AGE AT D EATH.
[Experience of the Granite Cutters’ International Association of America.]

Age at death.

20 years.
21 years.
22 years.
23 years.
24 years.
25 years.
26 years.
27 years.
28 years.
29 years.
30 year?.
31 years.
32 years.
33 years.
34 years.
35 years.
36 years.
37 years.
39 years.
40 years.
41 years.
42 years.
43 years.
44 years.
45 years.
46 years.
47 years.
48 years.
49 years.
50 years.
51 years.
52 years.
53 years.
54 years.
55 years.
5*1 years.
57 years.
58 years.
59 years.
60 years.
61 years.
62 years.
63 years.
64 years.
65 years.
66 years.
67 years.
' Exclusive of last three months of 1918.




Deaths
Deaths
from
from non
pulmonary tuberculous
tubercu­ respiratory
losis.

Deaths
from
all other
causes.

Deaths
from all
causes.
2
9
14
9
12
13
21
21
18
18
23
23
28
28
33
39
53
42
52
43
68
36
70
60
70
65
63
64
67
60
78
54
76
63
72
50
46
51
48
52
39
53
48
41
42
30
31
42

36

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.

19.—MORTALITY FROM PULMONARY TUBERCULOSIS, NONTUBERCULOUS
RESPIRATORY DISEASES, ANU ALL CAUSES AMONG THE GRANITE CUTTERS OF
THE UNITED STATES AND CANADA, 1906 TO 1918, BY AGE AT DEATH—Concluded.

T ab le

[Experience of the Granite Cutters’ International Association of America. J
Deaths
Deaths
from
from nonpulmonary tuberctilotis
tubercu­ :respiratory
losis.
diseases.

Age at death.

68- years.......................................................................................
69 vears.......................................................................................
70 years.......................................................................................
71 yea>rs..............................................................................
72 years.......................................................................................
74 years-................................................................
years........... .................................................. - ...................
76 years............................................................................. ......
77 years.......................................................................................
7Sye^rs..........- .......................................................... . . . .
79 years.......................................................................................
80 years...................................................................................
81 years......................................................................................
82 years.......................................................................................
83 y e a r s . ........................ - .....................................................
84 years.......................................................................................
85 years............................... ....................................................
86 years............, ...................,.....................................................
87 v e a rs______________________________ i _____________________

U N IT ED

1

3
2

1
1
i ;
2

A veraee ae-ft at d e a t h .. .............. ...........
Proportionate mortality............................... ....................
M ALSS,

5
5
4
2
3
2

1

Total.........................................

W H IT E

6
7
4
4
3
1
2

Deaths
from
all other
causes.
18
15
13
4
11
13
6
3
5
4
6
6

29
27
21
10
17
16
8
g
8

3
3
1

4
*4

5

7

4

7
6
6

4

1

1

1

991

264

966

2,221

47.4
44.6

51.9
11.9

50.9

S T A T E S R EG IST R A TIO N
AN D OVER).

AREA

41.0

Average age at death...............................................................

Deaths
from all
causes.

43.5

49.5

100.0

(20 Y E A R S OF AGE

57.5

58.9

56.6

'TUBERCULOUS AND NONTUBERCULOUS LUNG DISEASES.

The general death rate at all ages of granite cutters in the State
of Vermont during the period 1911-1917 was 20.11 per 1,000, but
from pulmonary tuberculosis alone the rate was 11V84. and from
nontuberculous respiratory diseases 2.76. The excess in the pul­
monary tuberculosis mortality falls, however, with divergent degrees
of severity upon different age periods, as clearly shown m Table 20.
20.—MORTALITY FROM PULMONARY TUBERCULOSIS, NONTUBERCULOUS
RESPIRATORY DISEASES, AND ALL CAUSES AMONG THE GRANITE CUTTERS OF
BARRE, VT., BY AGE GROUPS, 1911 TO 1917.
[Experience of the Granite Cutters’ International Association of America.]

T able

Pulmonary tuber­
culosis.
Age at death.

Number
exposed.

N o n tuberculous
respiratory dis­
eases.

Deaths.

Death
rate per
1,000.

Deaths.

Death
rate per
1,000.

All causes.

Deaths.

Death
rate per
1,000.

15to 19years
. . . . .......
20 to 24 years...............................
25 to 29 years .
.. . .
30 to 34 yeats...............................
35 to 39 years...............................
40 to 44 years...............................
45 to 49 vears...............................
50 to 54 years...............................
55 to 59 years...............................
50 to 64 years..............................
t>5 years and over........................

302
1,015
1,490
2,683
2,441
1,997
1,566
918
345
109
64

10
4
13
30
30
29
20
8
2

6.71
1.92
5. 32
15. 02
19.16
31.59
57. 97
73. 39
31.25

2
5
5
6
5
5
4
2

0.96
2. 05
2.50
3,83
5.45
14.49
36.70
31.25

2
12
11
23
44
53
40
36
17
10

1.97
8.05
5.28
9.42
22.03
33.84
43.57
104,35
155.96
156.25

Total....... ..............................

12,330

146

11.84

34

2.76

248

20'. 11




MOBTAJLlXY AMONG GRANITE-STONE WORKERS,

The

07

emphasizes the comparatively late oiiset of tu b ercu lo sis
granite cutters. The death rate does not assume seriou s
proportions until ages 4 0 •years and over. The nontuberculous
respiratory diseases are of comparatively small importance for ages
under 55.
Comparing the mortality from nontuberculous respiratory diseases
among the granite cutters of Barre, Vt,,- with that of the male popula­
tion (2 Massachusetts for 1911 to 1917, it is shown in Table 21 that
the death rate per 100,000 for the granite cutters was 275.8,. while for
the adult male population of Massachusetts it was only 179s.5. The
death rate from these diseases for granite cutters over 60 years of ager
is exceedingly high—3,468.2 per 100,000.
ta b le

a m on g

2 1 .—-M O R T A L IT Y FROM NONTUBERCULOUS R E SP IR A T O R Y DISEASES AMONG
TH E G R AN ITE CUTTERS OF B A R R E , V T ., COMPARED W IT H T H A T OF TH E M A LE
POPU LATION OF MASSACHUSETTS*1911-1917, B Y AGE GROUPS.

T a b le

[Data for granite cutters taken from experience of the Granite Cutters’ International Association
of America.]

Granite cutters of Barre,
V t.
Age at death.

Male population of Massa­
chusetts.

Death
Death
Number
rate per Population. Deaths. rate per
exposed. Deaths. 100,000.
100,000.

IS to 29 years........................ .................................
30 to 39 years........................................................
40 to 49 years............................ ............................
50 to 59 vears.........................................................
60 years and; over...................- ............................

2,807
4,524
3,563
1,263
173

7
11
10
6

154.7
308.7
791.8
3,468.2

3,427,.123
2,017,626
1,600.792
1,054,755
907,713

1,287
1,794
2,458
2,780
7,850

37. e
88.9
153.5
263.6
864.8

Total...............................................................

12,330

34

275.8

9,008,009

16,169

179.5

Standardized rates1............................................

275.8

124.6

1 Standardization based on-the age distribution of the granite cutters of Barre, Vt., 1911-19-17.

COMPARATIVE OCCUPATIONAL MORTALITY.

When the mortality rates at all ages for granite cutters are com­
pared with other occupations involving a considerable health hazard
the contrast is quite striking. It will suffice for the present purpose
to utilize the standard occupational mortality figures for England and
Wales for the period 1900-1902, no later data having been published.
The death rate for granite cutters at Barre, Vt., from pulmonary
tuberculosis was 11.84 per 1,000 exposed, for English tin miners 7.80,
for tool and cutlery makers 3.76, and for potters 2.72. Yet all of
the three trades referred to for purposes of comparison are recog­
nized as distinctly injurious to health, though none approach the
excessive death rates for granite cutters in the Barre district. This
excess is not maintained in a comparison of the mortality from nontuberculous respiratory diseases in the different occupations. In
eneral, for all of the three occupations the rates for these diseases are
igher than those for granite cutters. The nontuberculous death
rate for the granite cutters of Barre* Vt., was 2.76 per 1,000 exposed.
This compares with a rate of 8.22 for tin miners, 4.31 for potters,
and 3.61 for tool and cutlery makers. All crude death rates are,
however, in a measure misleading, and the true state of facts is only

f




38

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

shown with a c c u r a c y by an analysis of the mortality for divisional
periods of life. The importance of this is particularly emphasized in
considering the crude death rate for all causes, for while the death
rate of granite cutters was 20.11 per 1,000 it was 25.25 for tin miners,
16.94 for tool and cutlery makers, and 14.50 for potters. The facts
in detail are shown in Table 22:
2 2 .— M OR T AL IT Y FROM P U LM O N AR Y TU BER CU LO SIS. NONTUBERCULOUS
R E SP IR A T O R Y DISEASES, AN D A L L CAUSES AMONG T H E G R A N ITE CUTTERS OF
B A R R E , V T ., 1911 TO 1917, COMPARED W IT H T H A T AMONG TIN MINERS, POTTERS,
AND TOOL, IN STR UM ENT, AN D C U T L E R Y M AK ERS IN EN G LAN D A N D W A L E S , 1900
TO 1902, B Y AGE GROUPS.

T a b le

Death rate per 1,000.
England and Wales.
Age at death.

Granite
cutters of
Tool, in­
Barre, Vt.
strument,
Potters
(1911-1917). Tin miners
and
cutlery
(1900-1902). (1900-1902).
makers
(1900-1902).
Pulmonary tuberculosis.

15 to 19 y e a rs...........
.....................................
20 to 24 years..............
..............................................
25 to 34 years.............................................................................
35 to 44 years.............................................................................
45 to 54 years.............................................................................
55 to 64 years.............................................................................
65 years and over.....................................................................

3.91
9.69
23.75
61.67
31.25

0.25
1.73
7.04
11.84
16.81
17.11
18.21

0.62
1.34
2.00
3.79
7.14
4.37
.97

0.17
1.57
2.94
5.90
7.13
5.26
1.97

Total....................................................................................

11.84

7.80

2.72

3.76

Nontuberculous respiratory diseases.
15 to 19 years.......................................................................
20 to 24 years.............................................................................
25 to 34 years.............................................................................
35 to 44 years.............................................................................
45 to 54 years.............................................................................
55 to 64 years............................................................ *..............
65 years and over.....................................................................

0.56
2.25
4.43
19.82
31. 25

0.25
.69
3. 52
10.69
12.14
26.04
71.04

0.46
.58
.64
3. 29
10.78
23.10
35.04

0.23
.56
1.14
2.01
5.40
10.42
25.46

Total....................................................................................

2.76

8.22

4.31

3.61

(■

All causes.

15 to 19 years.............................................................................
20 to 24 years.............................................................................
25 to 34 years.............................................................................
35 to 44 years.............................................................................
45 to 54 years.............................................................................
55 to 64 years.............................................................................
65 years and over............ .........................................................

1.97
6.44
15.10
37.44
116.74
156.25

1.49
5.53
13.41
27.15
38.75
72.17
222.22

2.62
3.68
5.26
14. 52
31.64
54.15
118.25

2.09
3.32
6.32
13.65
25.97
42.05
100.65

Total....................................................................................

20.11

25.25

14.50

16.94

According to this table pulmonary tuberculosis does not assume
serious proportions until about the age 35, but beginning with age 45
and to the end of life the rates for granite cutters are decidedly in
excess of those for other dusty trades, and, of course, very much
more so than those for occupations not involving health-injurious
dust exposure.
The foregoing observations would seem to justify the conclusion
that the granite-cutters’ trade is not only inherently injurious to




39

MORTALITY AMONG GRANITE-STONE WORKERS.

health, but decidedly more so, as regards its specific liability to pul­
monary tuberculosis, than the corresponding employments in tin
mining, potteries, and tool and cutlery making.
There is nothing in the climate of New England or of the State of
Vermont which is suggestive of a predisposition to an excessive death
rate from pulmonary tuberculosis or from nontuberculous respiratory
diseases. An analysis of the mortality by months and seasons shows
that the death rate of granite cutters conforms in its fluctuations*
to the standard for the male population of the State of Massachu­
setts. The season showing the highest death rates is January to
March, while the lowest death rates are experienced in July to Sep­
tember. The mortality by months and seasons is shown in Table 23.
2 3 . — M O R T A L IT Y FROM PU LM O N AR Y TUBERCULOSIS AMONG THE G R A N ITE
C U TTER S OF N E W EN GLAND COMPARED W IT H T H A T OF THE M ALE PO PU LATIO N
OF M ASSACH USETTS, 1908-1918, B Y MONTHS AND Q U A R T E R S .

T a b le

Granite cutters of New Males of Massachusetts
England.
(all ages).
Month or quarter.
Deaths.1

Annual
death rate
per 100,000.

Deaths.2

Annual
death rate
per 100,000.

June............................................................................................
July.............................................................................................
August........................................................................................
September.................................................................................
October...................................................................................
November.................................................................................
December...................................................................................

67
55
62
60
60
56
51
42
42
47
53
46

1,081.5
887.8
1,000.8
968.5
968.5
904.0
823.2
678.0
678.0
758.7
855.5
742.5

2,236
2,295
2,535
2,408
2,345
1,994
1,970
1,921
1,730
1,817
1,792
2,071

154.9
159.0
175.6
166.8
162.4
138.1
136.5
133.1
119.8
125.9
124.1
143.5

January......................................................................................
February....................................................................................
March.........................................................................................
April...........................................................................................

Total................................................................................

641

862.3

25,114

145.0

January to March....................................................................
April to June............................................................................
July to September...................................................................
October to December..............................................................

184
176
135
146

990.1
947.0
726.4
785.6

7,066
6,747
5,621
5,680

163.2
155.8
129.8
131.1

Total................................................................................

641

862.3

25,114

145.0

1 September, 1908, to August, 1918.

2 January, 1908, to December, 1917.

EFFECT OF THE STONE INDUSTRY ON INFLUENZA M ORTALITY.

In all of the general mortality calculations the last three months of
1918, on account of the epidemic of influenza, have been omitted.
To make the present investigation as complete as possible, however,
Table 24, is included, which not only presents the influenza death
rate but also the case attack rate, as ascertained by personal inquiry
of every granite cutter in the Barre district. The table is for the
period from September, 1918, to April, 1919, inclusive, and shows an
annual attack rate from influenza and pneumonia combined of 672.6
per 1,000 exposed to risk at all ages (15 years and over). The attack
rate was highest in the age period 25 to 29 years, in which almost
every granite cutter was affected by the disease (979.8 per 1,000).
The annual death rate for all ages for the period under observation
(allowance being made for variations in the length of exposure) was
102.4 per 1,000. It may be questioned whether any other trade
suffered an equal mortality of over 10 per cent. The maximum mor­




40

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.

tality prevailed at ages 30 to 34, when the rate attained to the
almost incredible figure of 197.2 per 1,000 per annum, or nearly 20’
per cent. In other words, out of 251 granite cutters, ages 30 to 34,
exposed to risk for a period of eight months, 33, or 13.1 per cent,
died during this interval. At all ages, out of 1,405 cutters exposed
to risk 630, or 44.8 per cent7 were attacked with the disease during"
the eight months under observation. The number of deaths from
influenza was 33 and from pneumonia 63, and the combined mortality
96, or 6.8 per cent of the cutters exposed to risk. Of the 630 cases of
influenza and pneumonia 96 died., equivalent to a case-fatality rate
of 15.2 per cent. The highest fatality rate occurred at ages 30 to 34
years, at which 26 per cent died.
2 4 .—M O RTALITY FROM IN F L U E N ZA , PNEU M ON IA,1 AN D P U LM O N A R Y T U B E R ­
CULOSIS AMONG T H E G R ANITE CUTTERS OF B A R R E , V T ., D U R IN G T H E EPIDEM IC
PER IO D OF 191S-19,* B Y AG E.

T a b le

[Experience of the Granite Cutters’ International Association of America.]
Number of deaths from—
Annual
Num­ Cases attack
rate
of
in­
ber ex­
(cases Pulmo­
posed fluenza
per
nary
Sept. 1, and
Influ­
1,000
pneu­
tuber­ enza.
1918.
ex­
monia.
culosis.
posed).

Age.

15 to 19 years............................
2ft to 24 years............................
25 to 29 years............................
30 to 34 years............................
35 to 39 years............................
40 to 44 years............................
46 to 49 years............................
50 to 54 years............................
55 to 59 years............................
6® years and over.....................

36
110
173
251
268
226
174
105
42
20

18
56
113
127
125
102
52
25
8
4

750.0
763.6
979. 8
759:0
699.6
676.9
448.2
357. 2
285. 8
300.0

Total...............................

1,405

630

672.6

1
3
4
3
4
15

Annual
death
rate
from
influ­
enza
Influ­
and
enza
Pneu­
pneu­
and
monia. pneu­ monia
per
monia. 1,000
ex­
posed*

Case
fatality
rate
(deaths
per 100
cases
of in­
fluenza
and
pneu­
monia).

3
5
10
4
7
3
1

4
14
23
11
6
2
2
1

7
19
33
15
13
5
3
1

95.4
164. 7
197. £
84.0
86.2
43.0
42.9
35. 7

12.5
16. &
26.0
12.0
12.7
9.6
12.0
12.5

33

63

96

102.4

15.2

1 All forms.
* Including the months from September, 19l8, to April, 1919, both inclusive.

The mortality from pulmonary tuberculosis during the period
under observation was normal. As may be seen from Table 25,
there were only 15 deaths during this period, compared with 14
dbaths during the corresponding months of 1916-17 and 19 deaths
during the same eight months of 1915-16.
T a b le

2 5 .—D EATH S FROM SPECIFIED CAUSES AMONG TH E G R AN ITE CUTTERS O F
B A R R E , V T ., 15 Y E A R S OF AG E A N D O VER , DU RING N O R M AL PERIODS.
Number of deaths from—
Period.

September,
September
amber
September
September

1912,
1913,
1914
1915,
1916

to Aprils
to April,
to April,
to April,
to April,




1913...................................................................
1914.
.
. . ............. ....................
1915
....................................................
1916. . . . .......................................................
1917
. . .....................

Pulmonary
tubercu­
Influenza. Pneumonia.
losis.
12
12
13
19
14

1
3
%
1.

41

MORTALITY AMONG GRANITE-STONE WORKERS.

Table No. 26, showing the corresponding figures for telephone
employees^ while presenting a somewhat different age distribution,
is yet sufficiently comparable for the present purpose to emphasize
the truly extraordinary incidence of influenza among granite cutters
in the year 1918. At all ages the attack rate for granite cutters was
410 per 1,000 exposed, which compares with 155 for telephone em­
ployees. The death rate was 54.8 for granite cutters as against only
4.9 for the telephone industry, and the case fatality rate 13.4 per
cent for granite cutters as against only 3.2 per cent for telephone
employees.
2 6 .—M O R T A L IT Y FROM IN F L U E N ZA , BRONCHITIS, AND PNEUMONIA* AMONG
T H E G R AN ITE CUTTERS OF B A R R E , V T ., COMPARED W IT H T H A T AMONG TH E M ALE
E M PLO YEES OF TH E EASTER N GROUP OF T E L E P H O N E COMPANIES, B E L L SYSTEM ,
1918.

T a b le

[Data for telephone employees, from “ Influenza in th#eastern group of telephone companies, Bell system /1
1918, by Billings and Wynne, in Journal of Industrial Hygiene, vol. 1, No. 10.]
Annual attack rate
(cases per l r000 ex­
posed).

Annual death rate
per 1,000 exposed.

Case fatality rate
(deaths per 100
cases).

Age.
Tele­
Granite
Granite
Tele­
Granite
Tele­
cutters of phone cutters of phone cutters of phone
em­
Barre,
Barre,
em­
Barre,
em­
ployees.
ployees.
V t.
Vt.
V t.
ployees.
16 to 19 years.....................................................
20 to 24 y e a r s...................................................
25 to 34 years.....................................................
35 to 44 yeaifS- w.................................................
45 to 54 years.....................................................
55 to 64 years..............................................
65 years and over............................... .............

436
467
518
421
252
194

198
15ft
182
133
115
119
176

50.0
95.0
46.4
26.2
16.1

10.1
6.0
6.6
3.3
2.6
2.1

10.7
18.3
11.0
10.4
8.3

5.1
3.9
3.6
2.5
2.3
1.8

410

155

54.8

4.9

13.4

3.2

1 Lobar and broneho pneumonia.

An additional comparison is made in Table 27 with bituminous
coal miners and the industrial white male experience of the Metro­
politan Life Insurance Company for ages 15 to 65, inclusive. The
annual death rate from influenza and pneumonia combined was
213.6 for granite cutters, 50.1 for bituminous coal miners, and 22.3
for white males insured on the industrial plan.
2 7 .—M O R T AL IT Y FROM IN F L U E N ZA AND PNEUM ONIA AMONG TH E G R AN ITE
CUTTERS OF B A B R E , V T ., COM PARED W IT H T H A T AMONG BITUMINOUS COAL
MINERS AND A L L OCCUPIED W H IT E MALES, GROUP INSURANCE E X P E R IE N C E ,
M ETROPOLITAN L IFE INSURANCE COM PANY, OCTOBER TO DECEM BER, 1918.

T a b le

[Experience of the Granite Cutters7 International Association of America; Statistical Bulletin, Metro­
politan Life Insurance Company, vol. 1, No. 1.]
Annual death rate per 1,000.
Age.
Granite
cutters.1

Bituminous
coalminers.3

All industrial
white males.

15 to 25 years.............................................................................
25 to 45 years . •
...
....
45 to 65 years.................................................................... ........

164.4
270.0
82.0

29.5
62.1
44.4

17.5
32.6
11.7

Total........... ................ ......................... ..............................

213.6

50.1

22.3




1 75 deaths.

8 64 deaths.

42

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

The foregoing observations clearly indicate an extraordinary lack
of disease resistance on the part of an element of the population which
by occupational selection would suggest a comparative immunity.
It is regrettable that as far as known the subject should not have
attracted the attention of qualified observers. It is quite probable,
however, that the dust exposure in the industry, with the serious
damage done by the dust to the lungs of employees, was in a large
measure one of the causative factors explaining the relatively exces­
sive influenza mortality rate and case fatality.
EFFECT OF TRADE LIFE ON MORTALITY.

The epidemic of influenza illustrates an aspect of dust phthisis
which seems not to have heretofore received the requisite considera­
tion. In the Barre district the large majority of granite cutters have
been at work for many years, and therefore, at the time of the epi­
demic, they were in a physically damaged condition and peculiarly
liable to attack from an essentially respiratory affection, or at least
to the resulting complications. It is probably true of dust phthisis, as
also of influenza, that long-continued dust exposure results in lung
damage, with a resulting liability to most serious consequences at a
period of life when, broadly speaking, the normal incidence of pul­
monary tuberculosis is of diminishing importance. This fact is
brought out by an analysis of the occurrence of tuberculosis among
the granite cutters in the Barre, Vt., district according to the dura­
tion of trade life. This duration was ascertained by means of an
individual examination of the records of the Barre branch of the
Granite Cutters’ International Association of America, amplified
by personal inquiry, illustrated by the blank utilized in the present
investigation (see p. 138). The occupational history of the workmen
included a statement of the time employed in each occupation and
the length of employment in the occupation now followed. As far
as the writer knows, a similar extended investigation has never been
made for mortality purposes in a single dusty trade. The trade-life
inquiry of the New Jersey Bureau of Labor Statistics more than 20
years ago was merely with reference to the length of employment for
general purposes and not correlated to mortality. The present
investigation embraces the workmen still living, but also covers in
detail the years of trade life followed by 399 granite cutters who died
from pulmonary tuberculosis during the period 1886 to 1919.
The investigation is limited for the present purpose to pulmonary
tuberculosis. It shows, as may be seen from Table 28, that there
were no deaths from the disease during the first two years of trade
life as granite cutters, and comparatively few deaths during the first
eight years of trade experience. But beginning with the ninth year
the cases increase until a maximum is reached at the twenty-first
year of exposure, which would seem to conform to other observations
indicating that it requires about two decades of continuous dust
inhalation to produce conditions most-favorable to death from pul­
monary tuberculosis.9 If this conjecture is correct, then.the com­
paratively high average age at death from pulmonary tuberculosis
previously given as 47.4, or about six years later than in the normal
9More accurately, dust phthisis or fibroid lung disease, generally certified as pulmonary tuberculosis.




43

MORTALITY AMONG GRANITE-STONE WORKERS.

white male population, would be explained in a satisfactory manner.
But there arises the further question as to whether the disease
diagnosed as pulmonary tuberculosis is not in very truth a non­
tuberculous fibroid form of lung disease. Qualified observations
suggest a thorough and impartial medical inquiry conforming to the
methods followed by the Miners’ Phthisis Prevention Committee of
South Africa, but for present purposes it may be asserted without
fear of successful contradiction that the health-injurious conse­
quences of dust exposure in granite cutting and quartz mining under
normal conditions do not attain the most serious proportions until
the workman has been employed at his trade for about 21 years. A
new labor element recently introduced into the trade is therefore
not likely to show the effect of dust exposure common to the granitecutting industry when carried on under normal conditions, since the
length of injurious trade exposure is insufficient for the purpose.
M O R T A L IT Y FROM PU L M O N AR Y TUBER CU LO SIS AMONG T H E GR AN ITE
CU TTERS OF B A R R E , V T ., B Y Y E A R S OF E X P O SU R E TO G R A N IT E DUST AND AGE
A T D E A T H , 1886 TO 1919.

T a b le 2 8 —

[Where a dash (—) is used, age at death is not known.]
Exposure to Number
granite dust. ofdeaths.

40 36 ------68 53 -------------41 2 8 -----------10
10
16
7
11
13
16
21
19
17
23
23
27
23
25
23
16
21
17
11
12

51 47 40 39 31 28 __ __ __ __
51 51 46 45 42 39 33 — — —
61 55 51 42 42 34 28
47 46 41 37 32 23 —
54 48 48 40 40 37 37 36 — — —
64 55 45 44 39 39 39 38 36 34 32 — __
51 51 49 49 47 46 45 42 40 39 38 38 30 25 — __
59 56 54 53 51 50 48 47 44 43 43 38 37 37 37 36 36
68 62 57 46 46 45 45 43 42 42 35 30 27 24 — — —
64 63 60 57 57 56 53 51 51 49 46 45 43 43 42 40 25
65 62 62 61 55 54 53 53 51 49 48 47 44 43 41 41 40
72 68 65 62 61 57 56 55 54 49 48 46 45 45 44 42 41
67 62 61 60 58 56 56 52 50 50 49 49 48 47 46 43 42
65 64 63 58 56 55 55 54 54 52 50 49 49 49 48 47 46
61 59 58 57 56 53 52 51 50 48 48 47 46 45 44 44 44
65 63 61 56 55 55 54 53 53 53 52 52 52 52 50 50 50
72 68 56 56 54 52 51 50 49 47 47 47 47 45 44 42
62 62 62 61 61 58 56 53 53 52 52 51 48 48 48 47 46
64 63 58 58 57 55 55 53 52 51 50 50 48 46 42 41 40
62 60 59 58 57 56 52 51 50 48 45
74 57 57 56 55 54 54 54 50 43 41 —
57 57 50 42
60 54 52
64

Total.
61928°—22— Bull. 293------ 4




*

— — —
— —
40
41
42
45
44
46

39
40
41
44
43
46

38
36
40
42
43
43

37
34
40
42
41
42

37 36 — —

33
30
40
40
38
40

29
30
37 36 33 30
—
34
35
1
CO
CO

I year...
2-years..
8 years..
4 years.,
5 years.,
6 years.,
7 years.
8 years.
9 years.
10 years.
II years.
12 years.
13 years.
14 years.
15 years.
16 years.
17 years.
18 years.
19 years.
20 years.
21 years.
22 years.
23 years.
24 years.
25 years.
26 years.
27 years.
28 years.
29 years.
30 years.
31 years.
32 years.
33 years.
34 years.

Individual deaths, by age of granite cutter at death.

44

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.

The foregoing observations are further confirmed by a comparison
of the experience of the Bendigo quartz miners of Victoria, Australia.10
Reduced to the same basis, it is shown in Table 29 that during five
quinquennial periods the pulmonary tuberculosis death rate of
Bendigo miners increased from 485.0 to 1,024.0 per 100,000 exposed
to risk. The corresponding increase in the pulmonary tuberculosis
death rate of New England granite cutters was from 432.0 to 1,044.3
per 100,000 exposed, showing a strikingly similar change. It would
be difficult to find a more conclusive comparison showing clearly
that the conditions affecting granite cutters of New England are
even more detrimental to life than those affecting the Bendigo
miners, who have for many years attracted world-wide attention
as a body most liable to health-injurious conditions of work.
2 9 . — M O R T AL IT Y FROM PU LM O N AR Y TUBERCULOSIS AMONG T H E G R AN ITE
CUTTERS O F TH E N E W ENG LAN D STATES, 1896 to 1918, COMPARED W IT H T H A T OF
BENDIGO QUARTZ M INERS, VIC TO R IA, 1875 TO 1909.

T a b le

{Rates for granite cutters based on experience of Granite Cutters’ International Association of America.]

Comparison based on trade life.

Chronological comparison.

Death rate per 100,000.

Death rate per 100,000.
Period.

1875-1879 ........................
1880-1884..........................
1885-1889..........................
1890-1894..........................
1895-1899..........................
1900-1904..........................
1905-1909..........................
1910-1914..........................
1915-1918..........................

Granite cut­
ters of New
England.

Trade life by periods.
Bendigo
miners.

a 432.0
453.7
611.6
802.2
b 1,044. 3

485.0
569.0
800.0
846.0
1,024.0
1,008. 0
c 1,296.0

............................
1
2 .................................
3.....................................
4.....................................
5.....................................
6.....................................
7.....................................

Granite cut­
ters of N ew
England.
a 432.0
453.7
611.6
802.2
b 1,044. 3

Bendigo
miners.

485.0
569.0
800.0
846.0
1.024.0
1.008.0
c l , 296.0

a 1896-18$).
b Exclusive of influenza-epidemic period,
c 1905-1906 (six months).

The foregoing information is amplified by Table No. 30, showing
the mortality from all causes according to the duration of trade life,
and there is further included a correlation table (No. 31), showing
the ages and years of dust exposure of living granite cutters in the
Barre, Vt., district, numbering 1,137, as ascertained by personal
inquiry. According to this table there were no granite cutters at
work at an age higher than 74 years, the majority being around the
age period 35 to 39 years, the major portion of whom had been at
work as granite cutters from 10 to 24 years. In other words, without
a material introduction of new labor the workmen at present em­
ployed will within a few years reach the period of trade life most
fatal as regards pulmonary tuberculosis, although even at the present
time the death rate from this disease is more than 50 per cent of the
mortality from all causes (pulmonary tuberculosis 11.84 and all
causes 20.11 per 1,000).
10 See Report on the Ventilation of the Bendigo Mines, by Walter Summons, M. D ., Victoria Department
of Mines, Melbourne, 1906; and Report of an Investigation at Bendigo into the Prevalence, Nature, Causes,
and Prevention of Miner’ s Phthisis, by Walter Summons, M. D ., Melbourne, 1907.




MORTALITY AMONG GRANITE-STONE WORKERS.

45

T able 3 0 .— M O R T A L IT Y FROM A L L CAUSES AMONG TH E G R AN ITE CUTTERS OF THE
U N IT ED STATES AN D CAN ADA, 1889 TO 1917, COM PARED W IT H T H A T OF BENDIGO
QU ARTZ M INERS, V IC TO R IA , 1875 TO 1909.
[Rates for granite cutters based on experience of the Granite Cutters’ International Association of America.J
Chronological comparison.

Comparison based on trade life.

Death rate per 1,000.

Death rate per 1,000.

Granite cut­
Bendigo min­
ters of the
United States
ers.
and Canada.

Period.

1875-1879..
1880-1884..
1885-1889..
1890-1894..
1895-1899..
1900^1904..
1905-1909..
1910-1914..
1915-1917..

cut­
Trade life by periods. Granite
ters of the
Bendigo min­
United States
ers.
and Canada.

18.0
19.0
28.2
28.4
31.8
25.6
2 27.0

i 14. a
14.3
11.4
14.6

i 14.3
14.3
11.4
14. &
21.0
22.9

18.0
19.0
28.2
28.4
31.8
. 25.6
2 27.0

21.0

22.9
2 1905-1906 (six months).

T a b le

3 1 .— D ISTR IBUTIO N OF LIVIN G G R AN ITE CUTTERS OF B A R R E , V T ., B Y AG E
AN D Y E A R S OF E X P O SU R E TO G R AN ITE DUST, AUGUST, 1919.
Number of granite cutters exposed each classified number’of years to
granite dust.
Age.
lto4. 5to9.

10 to 15 to 20 to 25 to 30 to 35 to 40 to 45 to 50 to 55 to
Total.
19. 24.
29. 34. 39.
44. 49. 54.

l&'to 19 years.
20 to 24 years.
25 to 29 years.
30 to 34 year&.
35 to 39 years.
40 to 44 years.
45 to 49 years.
50 to 54 years.
55 to 59 years.
60 to 64 years.
to 69 years.
70 to 74 years.

95
138
193
223
184
143
85
32
10

Total.

92

169

194

205

179

132

44

17

1,137

OCCUPATIONAL DISTRIBUTION IN THE GRANITE INDUSTRY.

The following analysis, by occupation, makes clear the complex
nature of the industry and the importance of segregating employees
working under widely varying health-injurious conditions of em­
ployment :
Analysis by occupations of the granite-cutting industry of Barre, Vt., August
Occupation.

Granite cutters:
Hand tools..................................
Pneumatic tools.........................
Surfacing machines, in sheds..
Surfacing machines, outside. .
Lathes..........................................
Drills............................................
Sand-blast...................................
Tool sharpeners.................................
Lumpers:
General........................................
Grouters.......................................
Hook followers...........................
Boxers..................................................
Derrick men:
Boom............................................
Traveling crane..........................




Occupation.

No.
1

964

100
56
12
1

3
39
59
16
44
35
17
32

Polishers:
Hand........
Mill...........
Lathe........
Bed setters___
Sawyers............
Engineers........
Firemen...........
Electricians___
Machinists.......
Tool grinders. .
Tool carriers...
Draftsmen........
Foremen..........
Manufacturers.

,1919

.

No.

15
117
5
48
14
14
1
1

7
73
6

40
38

111

Total......................................... 1,869

46

DUST PHTH ISIS IN THE GRANITE-STONE INDUSTRY.

The relatively small number of some occupations unfortunately
prevents a conclusive statistical analysis, but as far as possible the
principal occupational distinctions are maintained in the present
discussion, and particularly is this true for manufacturers and fore­
men, who, though representing a group supposed to be relatively
free from health-injurious conditions, nevertheless vary to a measur­
able degree in the health hazard of the employment.
PHYSIQUE OF GRANITE WORKERS.

Aside from the occupation as such, the disease incidence is affected
by physical selection and by external conditions, which require to be
taken into account. The opinion generally prevails that stone
workers are a physically selected class who because of superior health
should be less liable to pulmonary tuberculosis than other workers,
if conditions favorable to disease development did not arise out of
the industrial problems dealt with. It was therefore thought best
to determine in each and every case the height and weight, as well
as the relative weight, of the men employed as granite cutters in the
Barre district. This important information was secured by personal
interview and with the hearty cooperation of the wage earners
themselves. The results of this important investigation are for the
present given only in general outline, but sufficiently for the purpose
of emphasizing the clearly superior physical characteristics of granite
cutters employed in the Barre district in August, 1919. It is im­
portant to keep this point in mind, for conditions were undoubt­
edly better when the occupation was first taken up, there having,
no doubt, been some impairment during the intervening years of
trade life.
Table 32 shows the proportionate age distribution of the granite
cutters of Barre, Vt., as compared with male employees in specified
dusty trades, by occupations, while Table 33 gives the number and
per cent of the granite cutters in each occupational group.
T a b l e 3 2 . — P R O POR TIONATE

AGE D ISTR IBUTIO N OF LIVIN G MALES IN THE
GRAN ITE-CU TTIN G IN D U ST R Y OF BAR R E , V T ., COMPARED W IT H T H A T OF M ALE
EM PLOYEES IN SPECIFIED D U ST Y TRADES, B Y OCCUPATION GROUP.
G R A N IT E -C U T TIN G IN D U S T R Y .1

Per cent in each specified age group.
Occupation group.
10 to 13 14 to 15 16 to 20 21 to 44 45 and
over.
Engineers, firemen, electricians, and machinists...........................
Tool sharpeners......................................................................................
Polishers, bed setters, and sawyers...................................................
Manufacturers and foremen.................................................................
Lumpers, boxers, and derrick men...................................................

4.35
47. 82
47. 83
53. 85
46.15
10.05
49.25
40.70
62. 42
.67
36.91
12. 32
0.49
59.60
27.59
3.52
72.12
.09
24.27
Tool grinders and tool carriers...........................................................
6.33
16.45
53.17
10.13
13.92
Draftsmen...............................................................................................
20.00
10.00
Total..................................................................................................
1 August, 1919.




.27

.80

7.33

64.21

27.39

47

MORTALITY AMONG GRANITE-STONE WORKERS.

3 2 .—PR O POR TIONATE AG E D IST R IB U T IO N OF LIVIN G M ALES IN TH E
GR ANITE-CUTTIN G IN D U S T R Y OF B A R R E , V T ., COM PARED W IT H T H A T OF M ALE
EM PLO YEES IN SPECIFIED D U ST Y T R A D E S , B Y OCCUPATION GROUP—Concluded.

ta b le

OCCU PATIONS W IT H E X PO SU R E TO M IN ER A L D U S T . *

Per cent in each specified age group.
Occupation group.
45 and
10 to 13 14 to 15 16 to 20 21 to 44 over.
Whitewashes..............................................
Plasterers......................................................
Marble and stone yards..............................
Color mixers (not paint)............................
Paper hangers, apprentices and helpers.
Paint factories..............................................
Holders..........................................................
Lacquerers, j apanners, enamelers...........
Lithographers..............................................
Potteries........................................................
Grass blowers................................................
Brick, tile and terra-cotta factories.........
Xime, cement, and gypsum factories----Asbestos workers.........................................
Mirror makers..............................................
Glass factories (excluding blowers).........
Core makers..................................................
M ca workers................................................

0.06
.04
.04
.05
.08

0.24
. 29~
.53
1.75
1.00
1.92
.03

1.88

.21

.61
.17
.17
.14
.64
.02

.22

Total.

.14
2.31
.11
2.28
. 88’
1.25
1.16
6.70
2. 49
3.70
1.64

10.11
14.56
23. 52
24. 57
37.04

65. 28
63. 31
76. 81
64. 48
71.09
74. 44
70.17
55. 68
64. 56
51. 85

53.93
32.35
27.73
25. 29
24. 62
18.87
18. 79
17.71
17.62
17.26
16.90
16. 83
15. 98
14. 03
13.97
13. 46
8. 36
7.41

12.43

66.00

19.71

3.91
6.83
7.84
13.29
9. 24
15.44
7.19
14. 20
16. 96
16.91
6.18
15. 80

11.88

41. 86
60. 49
63. 88
59.67
65. 09
63. 69
73. 99

66.21

1 Compiled from Report of Bureau of the Census on Occupation Statistics, 1910.
3 3 .—AGE D ISTR IBUTION OF LIVIN G EM PLOYEES A N D M AN U FACTU R ER S IN
TH E GR ANITE-CUTTIN G IN D U ST R Y OF B A R R E , V T ., AU G U ST, 1919, B Y OCCUPATION
GROUPS.
NUM BER.

T a b le

Age.

Polish­ Engi­
Lump­ ers, bed neers,
Tool
Manu­
ers,
setters, firemen, grind­
factur­
Tool
electri­ ers and Drafts­
and
Cutters. sharp­ boxers
ers
and
men.
and
saw­
cians,
eners. derrick
tool
fore­
yers. and ma­ carriers.
men.
chin­
men.
ists.

15 to 19 years............................
20 to 24 years............................
25 to 29 years............................
30 to 34 years............................
35 to 39 years............................
40 to 44 years............................
45 to 49 years............................
50 to 54 years............................
55 to 59 years............................
60 to 64 years............................
65 years and over....................

28
95
138
192
224
184
143
86
31
10
6

3
7
7
4
11
5
1
1

20
23
31
34
26
13
14
18
15
4
5

16
22
23
17
22
18
21
28
19
11
2

1
4
4
2
4
6
1

Total...................................

1,137

39

203

199

23

79

4. 35

72.14
10.13
3. 80

1

57
8
3

3
1
5
2

Total.

1

1
2
£
20
26
36
26
21
4
2
2

131
159
218
279
313
257
220
169
72
33
18

40

149

1,869

20.00
22.50
25.00
12.50
10.00

7.01
8. 51
11.66
14.93
16.76
13. 76
11.78
9.04
3.83
1.76
.96
100.00

8
9
10
5
4
1
2

PER CENT.
15 to 19 years............................
20 to 24 years............................
25 to 29 years............................
30 to 34 years............................
35 to 39 years............................
40 to 44 years............................
45 to 49 years............................
50 to 54 years............................
55 to 59 years............................
60 to 64 years............................
65 years and over....................

2.46
8.36
12.14
16. 88
19. 70
16.18
12. 58
7.56
2.73
.88
.53

Total...................................

100.00




7.69
17.95
17.96
10. 26
28. 20
12.82
2.56
2.56
100.00

9. 85
11.33
15. 27
16.75
12. 81
6.40
6.90
8.87
7.39
1.97
2.46

8.04
11.05
11.57
8. 54
11.05
9.05
10. 55
14.06
9.55
5.53
1.01

100.00

100.00

4. 35
17. 39
17. 39
8.70
17. 39
26. 08
4.35

100.00

3. 80
1.27
6.33
2.53

2.50

0.67
1. 34
6.04
13.42
17. 46
24.17
17. 45
14. 09
2.68
1.34
1.34

100.00

100.00

100.00

2.50
5.00

48

DUST PH TH ISIS

IN

THE GRANITE-STONE INDUSTRY.

Table 34 presents the age, height, weight, and relative weight, by
which is meant pounds per unit of height. These figures for granite
cutters, coal miners, and all occupied males in the ordinary mortality
experience of the Prudential Insurance Company are compared with
the medico-actuarial standards. According to this table the average
height of granite cutters was below the accepted normal for the
different groups used for purposes of comparison, including the
medico-actuarial standard, which is representative chiefly of the
more prosperous professional or mercantile elements. Leaving out
of consideration the different age groups, it appears that the average
height of granite cutters was 66.6 inches, of coal miners 67.8 inches*
of all occupied males 68.1 inches, and of the medico-actuarial standard
68.5 inches. In contrast to this difference in height is the marked
superiority in weight. The average weight of granite cutters was
160.8 pounds, of coal miners 155.1 pounds, of all occupied males
157.0 pounds, and of the medico-actuarial standard 156.2 pounds.
These differences, reduced to a basis of relative weight, show that
granite-cutters7 weight on the average was 2.41 pounds per inch of
height, coal miners’ 2.29 pounds, and all occupied males’ 2.30 pounds,
while according to the medico-actuarial standard the expected aver­
age would be 2.28 pounds. These differences are so striking and so
uniform as to require most careful consideration. They clearly
emphasize the physical superiority of granite cutters in comparison
with other labor elements of our general population. The comparison
is even more impressive when it is considered that the averages for
insurance applicants are based on measurements at the time of appli­
cation, while the averages for granite cutters were obtained after many
years of trade life and inclusive of all elements, whether or not
eligible for life insurance.
T a b le 3 4 .— AVERAGE

H EIG H T AND W E IG H T OF T H E GRAN ITE CUTTERS OF B A R R E ,
V T ., COMPARED W IT H THOSE OF COAL MINERS, A L L OCCUPIED MALES, AN D TH E
M EDICO-ACTUARIAL STAN D AR D .

[Data for coalminers (1896-1915) and all occupied males (1896-1914) from Prudential ordinary experience.!

Average height (inches).

Age.

Gran­
Coal
ite
cut­ min­
ers.
ters.

MedAll
icooccu­ actupied ' aria 1
males. stand­
ard.

Average weight (pounds).

Relative weight (pounds
per inch).

Gran­ Coal
ite
cut­ min­
ers.
ters.

MedAll
ico- Gran­
Coal
occu­ actu- ite
pied
aria 1 cut­ min­
ers.
males. stand­ ters.
ard.

MedAll
icooccu­ actupied
ariarl
males. stand­
ard.

15 to 24 years.........
25 to 34 years.........
35 to 44 years.........
45 to 54 years.........
55 to 64 years.........
65 years and over .

66.4
66.8
66. 4
66.4
67.6
67.2

67.8
68.4
67.5
67.8
67.0
67.0

68.1
68.3
68.1
67.9
67.8
67.9

68.3
68.5
68.5
68.5
68.4
66.5

147.8
157.6
J63. 8
165.6
166.7
164.7

146.7
157.6
155.1
157.1
151.4
165.0

145.0
155.0
160.0
163.0
163. 0
162.0

147.0
154.6
160.9
164. 8
165.3
166.0

2.23
2.36
2.47
2.49
2. 47
2.45

2.16
2.30
2.30
2.32
2.26
2.46

2.12
2.26
?2.35
2.40
2.40
2.38

2.15
2.26
2.35
2.41
2.42
2.50

T otal..............

66.6

67.8

68.1

68.5 160.8

155.1

157.0

156.2

2. 41

2.29

2. 30

2.28

The writer is not aware of more conclusive evidence concerning
the physical status of granite cutters in its relation to an excessive
incidence of pulmonary tuberculosis. Normally, tubercular disease
and deficiency in weight go together, whereas this disease is generally
less common among those who are overweight. Regardless of this




49

MORTALITY AMONG GRANITE-STONE WORKERS.

point of view, granite cutters are shown to have experienced the
greatest liability to pulmonary tuberculosis of all those engaged in
the representative dusty trades.
PHYSIQUE IN RELATION TO RACE.

A factor of importance in this connection is the nativity of the
workmen, for a large proportion of the granite cutters in the Barre
district are from the south of Europe, especially Italy and Spain.
Since these southern Europeans are of lower stature than the natives
of Scotland and the United States, the subject has been made one of
Special inquiry, and the facts are set forth in the required detail in
Table 35.
T a b le 3 5 .—COM PARATIVE AN T H R O P O M E TR Y OF G R AN ITE CUTTERS OF B A R R E , V T .,
AUGUST, 1919, B Y BIRTHPLACE OF W O R K M A N ’ S M OTH ER.

Average height (inches).

Age.
Scot­
Italy. land.

Average weight (pounds).

Med-]
icoScot­
Spain. actuarial Italy. land.
stand­
ard.

Relative weight (pounds
per inch).

Med­
icoSpain. actu­ Italy. Scot­
arial
land.
stand­
ard.

MedicoactuSpain.
arial
stand­
ard.

15 to 24 years.........
25 to 34 years.........
35 to 44 years.........
45 to 54 years.........
55 to 64 years*.......
65 years and over .

66.6
66.5
65.8
63.9
66.7
65.0

66.2
65.8
67.3
66.5
67.2
65.2
66.5
67.5
67.9
64.0
68.0 ...........

68.3
68.5
68.5
68.5
68.4
66.5

148.0
158.0
165.5
168.6
165.1
141.0

140.7
152.9
157.7
165.7
164.9
180.0

150.8
153.7
161.9
175.0
170.0

147.0
154.6
160.9
164.8
165.3
166.0

2.22
2.38
2.51
2.64
2.48
2.17

2.12
2.27
2.35
2.45
2.43
2.65

2.29
2.31
2.48
2.63
2.66

2.15
2.26
2.35
2.41
2.42
2.50

Total................

65.7

67.3

68.5 162.4

158.5

155.1

156.2

2.47

2.36

2.35

2.28

66.0

Workmen of Italian, Scotch, and Spanish descent constitute 74.6
per cent of the granite cutters of the Barre district. The average
height was 65.7 inches for natives of Italy, 67.3 inches for natiyes of
Scotland, and 66 inches for natives of Spain, as compared with the
medico-actuarial standard of 68.5 inches. The average weight was
162.4 pounds for natives of Italy, 158.5 pounds for natives of Scot­
land, 155.1 pounds for natives of Spain, and 156.2 pounds according
to the medico-actuarial standard. Reducing these figures to a com­
mon basis, the relative weight of natives of Italy was 2.47 pounds
per inch of height, of natives of Scotland 2.36 pounds, of natives of
Spain 2.35 pounds, as compared with the medico-actuarial standard
of only 2.28 pounds,, Thus the general physical superiority of gran*
ite cutters at present at work in the Barre district indicates clearly a
superior degree of physical resistance to a disease normally associated
with deficiency in weight.
This aspect of the problem is of such importance that it has seemed
advisable to add Table 36, showing in detail the distribution of
weights above and below the standard, with a due regard to ages
attained. This table shows that for persons of Italian descent 80.7
per cent are overweight, of Scotch descent 54.6 per cent, and of
Spanish descent 74.5 per cent. For the remaining granite cutters of
the Barre district, largely native Americans, the percentage of over­
weight Was 64.0.




50

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

T a b le 3 6 .—DISTRIBUTION OF GRANITE CUTTERS OF B A R R E , V T .. OF FOREIGN
DESCENT, ACCORDING TO O V E R W E IG H T AND U N D E R W E IG H T , AUGUST, 1919, B Y
AGE GROUP.
NUM BER OF C U TTER S OF IT A L IA N D ESCEN T.
Age.
15 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 years
and
Total.
years. years. years. years. years.
over.

Pounds.

Above standard weight:
50 and over..........................................
45 to 49.................................................
40 to 44.................................................
35 to 39.................................................
30 to 34.................................................
25 to 29.................................................
20 to 24.................................................
15 to 19.................................................
10 to 14.................................................
5 to 9...................................................
1 to 4...................................................
Total.............................................
Standard weight.......................................
Below standard weight:
1 to 4...................................................
5 to 9...................................................
10 to 14..........................................
15 to 19.................................................
20 to 24.................................................
25 to 29.................................................
30 to 34.................................................
35 to 39.................................................
40 to 44.................................................
45 to 49.................................................
50 and over..........................................

6
2
10
5
9

4
4
3
2
7
8
15
22
29
26
20

14
3
6
10
15
27
24
29
25
26
19

4
5
8
3
7
11
11
10
10
10
6

34

140

198

85

6

5

3

14

2.5

15
13
3
2

9
12
4
3
2
1

3
7
4
3
1

32
38
12
9
4
1

5.6
6.6
2.1
1.5
.7
i

2

5
2
1
1

1

23
14
17
15
29
46
57
63
76
67
54

1
2

4

3

1

1

33

31

18

4

1

96

Per ct.
84. 7
2.1
13.2
100.0

Per ct.
80. 2
2. 8
17.0
100.0

P erct.
50.0

Per ct.

50.0
100.0

100.0
100.0

Per ct.
80. 7
2. 5
16.8
100.0

9

4.0
2.5
3.0
2.6
5.1
8.0
10.0
11.0
13.2
11.7
9.4

461

Per ct. Per ct.
78.2
Overweight................................................
79.1
Standard.....................................................
3. 4
18.4
Underweight..............................................
20.9
Total.................................................
100.0
100.0

Total.............................................

Per
cent
of to­
tal.

.

100.0

NUM BER OF C U TTER S OF SCOTCH DESCENT.
Above standard weight:
50 and over..........................................
45 to 49.................................................
40 to 44................................................
35 to 39.................................................
30 to 34.................................................
25 to 29.................................................
20 to 24.................................................
15 to 19.................................................
10 to 14.................................................
5 to 9..................................................
1 to 4................................................
Total..............................................
Standard weight........................................
Below standard weight:
1 to 4.................................................
5 to 9.................................................
10 to 14.................................................
15 to 19.................................................
20 to 24.................................................
25 to 29.................................................
30 to 34..............................................
35 to 39.................................................
40 to 44.................................................
45 to 49.................................................
50 and over..........................................
Total.............................................
Overweight................................................
Standard.....................................................
Underweight..............................................
Total...................................................




2
1
1

5
2
7

3
1

3
5
4
3
19
3
1
9
6
2

1
1
1
1
3
2
2
2
8
4
10
35 |
1 I
6
10
10
5
2
1

1

1
4
3
5
4
5
7
30 1
1 1
8
2
4
2
1
1

1
3
1
5
9

1
2

1
2
1
1

1

2
1
3
2
4
7
6
13
18
19
27
102
6

1.1
.5
1.6
1.1
2.1
3.7
3.2
7.0
9.6
10.2
14.5

20
23
20
9
4
2
1

10.7
12.3
10.7

4

19

34

18

4

Per ct.
63.6

Per ct.
46.4
7.3
46.3
100.0

Per bt.
50.0
1.4
48.6
100.0

Per ct.
61.3
2.0
36.7
100.0

P er ct.
64.3
7.1
28.6

P er ct.
100.0

Per ct.
54.6
3.2
42.2

100.0

100.0

100.0

36.4
100.0

3.2

4.8

2.1
1.1
.5

79

100.0

MORTALITY AMONG GRANITE-STONE WORKERS.

51

3 6 .—DISTR IBU TIO N OF G R AN ITE CUTTERS OF B A R R E , V T ., OF F O R EIG N
DESCENT, ACCORDING TO O V E R W E IG H T AND U N D E R W E IG H T , AUGUST, 1919, B Y
AGE GROUP—Concluded.

T a b le

NUMBER OF CUTTERS OF SPANISH DESCENT.
Age.
15 to 24 25 to 34 34 to 44 45 to 54 55 to 64 65 years
and
Total.
years. years. years. years. years.
over.

Pounds.

Above standard weight:
50 and over..........................................
45 to 49.................................................
40 to 44.................................................
35 to 39.................................................
30 to 34.................................................
25 to 29...............................................
20 to 24.................... : ...........................
15 to 19...............................................
10 to 14.................................................
5 to 9...............................................
1 to 4..................................................

4
4
4
2
6
1

7
4
2
1
6
5

4
2
3
1

1

Total.............................................

22

26

16

2

Standard weight.......................................
Below standard weight:
1 to 4..................................................
5 to 9.................................................
10 to 14.................................................
15 to 19.................................................
20 to 24.................................................
25 to 29.................................................
30 to 34.................................................
35 to 39.................................................
40 to 44.................................................
45 to 49.................................................
50 and over..........................................

1

2

5

7
4
1
1

Total.............................................
Overweight................................................
Standard.....................................................
Underweight..............................................
Total....................................................

1
1

1
1
1
3

1

1

1

Per ct.
78.5
3.6
17.9
100.0

Per ct.
63.4
4.9
31.7
100.0

1

1.1

1
2
1
16
8
10
6
15
7

1.1
2.2
1.1
17.8
8.9
11.1
6.7
16.7
7.8

67

1
1

I
i
........... 1............
|
i
I
I
........... ! .......... 1
............. 1..............i..............
5
13
2 i.............

Per
cent
of to­
tal.

3

3.3

13
5
1
1

14.4
5.6
1.1
1.1

!
20

Per ct.
88.9

Per ct.
100.0

Per ct.
100.0

11.1
100.0

100.0

100.0

Per ct.

Per ct.
74.5
3. 3
22.2
100.0

100.0

3
7
4
7
12
13
18
20
35
32
34
185
8

1.0
2.4
1.4
2.4
4.2
4.5
6.2
6.9
12.1
11.1
11.8

1
1
1
1

34
18
23
13
6

11.8
6.2
8.0
4.5
2.1

1

2

.7

96
Per ct.
64.0
2. 8
33. 2
100.0

100.0

NUM BER OF CU TTERS OF OTHER DESCENT.
Above standard weight:
50 and over.........................................
45 to 49.................................................
40 t o 44.................................................
35 to 39.................................................
30 to 34.................................................
25 to 29.................................................
20 to 24.................................................
15 to 19...........................................
10 to 14.................................................
5 to 9 ....................................................
1 to 4 ...................................................
Total.............................................
Standard weight.......................................
Below standard weight:
1 to 4.....................................................
5 to 9 .....................................................
10 to 14.................................................
15 to 19.................................................
20 to 24.................................................
25 to 29.................................................
30 to 34.................................................
35 to 39.................................................
40 to 44.................................................
45 to 49.................................................
50 and over..........................................

1

1
7
4
5
7
3
28
3
5
3
1




5
5
2
2

1

10
Per ct.
Overweight................................................
68.3
Standard.....................................................
7.3
24,4
Underweight..............................................
Total....................................................
100.0
Total.............................................

1
1
2
3
2
3
3
8
10
12
9
54
1

1
3
1
6
3
7
5
9
7
6
48
4
18
2
5
5
1

1
1
3
3
5
3
5
5
13
39

5
7
14
5
4

1

14
Per ct.
78. 3
1.4
20.3
100.0

32
Per ct.
57.1
4. 8
38. 1
100.0

2
1
2
1
5
1
2
14

1
1
2

35
Per ct.
52.7

5
Per ct.
73. 7

Per ct.
100.0

47.3
100.0

26. 3
100.0

100.0

2.8

52

DUST PHTHISIS USF THE GRANITE-STONE INDUSTRY.
SANITARY CONDITIONS.

The foregoing observations emphasize the important conclusion,
that granite cutters represent physically a superior class of risk.
Practically the same conclusion applies to the general environment
as determined by a housing survey, with particular reference to both
outside and inside sanitary conditions. This survey was made in
conformity to the usual methods of inquiry as shewn by the general
blank used (see p. 138). The report on outside sanitary conditions in
this part of the investigation was made by a trained sanitary engi­
neer, and each house was personally visited, the results of the investi­
gation being made a matter of record at the time of the inspection.
These outside sanitary conditions represent general observations
corresponding to the method followed in the tenement-house survey
of the Bureau of Labor Statistics of Massachusetts.® The inside
sanitary conditions are with reference to light and air and general
cleanliness, while the room accommodation is with reference to the
total number of rooms and persons in the household. The results
of this investigation do not seem to require extended consideration.
The tabular analysis shown in Table 37 differentiates houses of
(1) manufacturers and foremen, (2) draftsmen, (3) engineers, fire­
men, electricians, and machinists, (4) tool grinders and tool carriers,
(5) polishers, bed setters, and sawyers, (6) lumpers, boxers, and der­
rick men, (7) tool sharpeners, and (8) granite cutters.
Table 3 7 .—PR OPOR TIO NATE D ISTRIBUTION OF M AN U FACTU R ER S AND EM PLO YEES
IN TH E GRANITE-CUTTING IN D U ST R Y OF B A R R E , V T ., ACCORDING TO HOME H Y ­
GIENIC CONDITIONS AN D TUBERCULOSIS H ISTO R Y IN F A M IL Y , AUGUST, 1919, B Y
PERSONS PER ROOM.
M AN U FAC TU R ER S AND FOREMEN.

Outside sanitary
conditions.

Inside sanitary conditions.
Persons per room.

Num­
ber.

Cleanliness.

Light and air.
Good.

Good.

0.1 to 0.5.........................
6.5to 1.0..........................
1 .a to l.5 „
1.5 to 2.0.........................
2.0 and over...................

39
92
15
3

Total........................

149

Fair.

Bad.

Good.

Fair.

Fair.

Bad.

Bad.

Per ct. Per ct. Per ct. Per ct. Per ct. Per ct. Per c t Per ct. Per ct.
74.4
76.9
0.0
76.9
23.1
0.0
23.1
25.6
0.0
53.3
46.7
.0
54.3
.0
55.4
44.6
45.7
.0
33.3
.0
40.0
.0
33.3
66.7
66. 7
60.0
.0
33. 3
66.7
.0
.0
66.7
33.3
.0 100.0
.0
57.0

43.0

.0

59.1

Tuber­
culosis
his­
tory in
family.

Per ct.
23.1
27.2
20.0
.0

40.9

.0

57.7

42.3

.0

24.8

DR AFTSM EN .
0.1 to 0.5 .< .....................
0.5 to 1.0.........................
1.0 to 1.5................
1.5 to 2.0.........................
2.0 and over.............

6
30
4

as. 3
53.3
25.0

16.7
43.3
75.0

0.0
3.4
.0

100.0
53.3
50.0

0.0
48.7
50.0

0.0
.0
.0

100.0
56.7
75.0

0.0
43.3
25.0

0.0
.0
.0

53.3
30.0
25.0

Total........................

40

55.0

42.5

2.5

60.0

40.0

.0

65.0

35.0

.0

30.0

a Twenty-third annual report of the Massachusetts Bureau of Labor Statistics, Boston, 1893.




53

MORTALITY AMONG GRANITE-STONE WORKERS.

T ab le 3 7 .—PRO PO R TIO NA TE D IST R IBU T IO N OF M AN U FAC TU R ER S A N D E M P LO Y E ES
IN TH E G R AN ITE-CUTTING IN D U S T R Y OF B A R R E , V T ., ACCORDING TO HOME H Y ­
GIENIC CONDITIONS AN D TU BERCU LOSIS H IS T O R Y IN F A M IL Y , AU G U ST, 1919, B Y
PERSONS PER ROOM—ConcludedENGINEERS, FIREM EN, ELECTR ICIAN S, AN D M ACH IN ISTS.
Outside sanitary
conditions.

Inside sanitary conditions.
Persons per room.

Num­
ber.

Cleanliness.

Light and air.
Good.
*

Good.

0.1 to 0.5..........................
0.5 to 1.0..........................
l.Oto 1.5..........................
1.5to 2.0..........................
2.0 and over...................

3
12
7
1

Total........................

23

Fair.

Bad.

Good.

Fair.

Fair.

Bad.

Tuber­
culosis
his­
tory in
family.

Bad.

Per ct. Per ct. Per ct. Per ct. Perct. Per ct. Perct. P er ct. P er ct. Per ct.
66.7
33.3
0.0
66.7
33.3
0.0
66.7
0.0
33.3
66.7
58.4
25.0
58.3
16.7
33.3
8.3
25.0
8.3
66.7
8.3
28.6
57.1
14.3
28.6
71.4
.0
71.4
28.6
.0
57.1
.0 100.0
.0
.0 100.0
.0
.0
.0 100.0
.0
26.1

60.9

13.0

30.4

65.2

4.4

30.4

65.2

4.4

30.4

TOOL GRIN DERS AND TOOL CAR R IER S.
0.1 to 0.5..........................
0.5 to 1.0..........................
l.Oto 1.5..........................
1.5 to 2.0..........................
2.0 and over...................

9
40
23
4
3

44.4
22.5
4.3
25.0
.0

44.4
70.0
86.9
50.0
66.7

11.2
7.5
8.8
25.0
33.3

55.6
22.5
4.3
.0
.0

44.4
75.0
95.7
100.0
100.0

0.0
2.5
.0
.0
.0

66.7
25.0
4.3
25.0
.0

33.3
72.5
95.7
75.0
100.0

0.0
2.5
.0
.0
.0

22.2
5.0
4.3
.0
33.3

Total........... ...........

79

19.0

70.9

10.1

19.0

79.7

1.3

22.8

75.9

1.3

7.0

POLISHERS, BED SET TE R S, AND S A W Y E R S .
0.1 to 0.5..........................
0. 5 to 1.0.........................
1.0 to 1.5..........................
1.5 to 2.0..........................
2.0 and over...................

27
97
66
6
3

22.2
20.6
6.1
.0
.0

70.4
74.2
75.8
83.3
100.0

7.4
5.2
18.1
16.7
.0

18.5
19.6
6.1
.0
.0

77.8
78.4.
89.4
83.3
100.0

3.7
2.0
4.5
16.7
.0

30.0
24*4
8.5
.0
.0

65.0
73.2
86.4
80.0
100.0

5.0
2.4
5.1
20.0
.0

29.0
17.5
34.8
33.3
33.3

Total.......................

199

15.1

74.9

10.0

14.1

82.4

3.5

18.3

77.5

4.2

25.6

LUMPERS, BO X E R S, AND D E R R IC K MEN.
0.1 to 0.5..........................
0.5 to 1.0..........................
l.Oto 1.5..........................
1.5 to 2.0..........................
2.0 and over...................

27
98
64
12
2

11.1
13. 3
3.1
8.3
.0

77.8
76.5
79. 7
58. 3
100.0

11.1
10. 2
17.2
33.4
.0

11.0
11.2
3.0
8.3
50.0

85.2
87.8
97.0
83.4
50.0

3.8
1.0
.0
8.3
.0

12.5
14.6
3.2
16.6
.0

83.3
84.3
96.8
83. 4
100.0

4.2
1.1
.0
.0
.0

7.4
18.4
23. 4
25.0
.0

Total........................

203

9.4

76.4

14.2

8.9

89.7

1.4

10.6

88.3

1.1

18.7

TOOL SH ARPENER S.
0.1 to 0.5..........................
0.5to 1.0..........................
1 .0 to l.5 ..........................
1.5 to 2.0..........................
2*0 and over. .................

8
20
11

0.0
30.0
27.3

100.0
50.0
54.5

0.0
20.0
18.2

0.0
35.0
27.3

100.0
65.0
72.7

0.0
.0
.0

0.0
30.0
27.3

100.0
70.0
72.7

0.0
.0
.0

25.0
40.0
36.4

Total........................

39

23.1

61.5

15.4

25.6

74.4

.0

23.1

76.9

.0

35.9

G R AN ITE CU TTER S.
0.1 to 0.5..........................
0.5to 1.0..........................
1.0 to 1.5..........................
1.5 to 2,0..........................
2.0 and over...................

72
566
445
39
15

20.8
13. 2
6. 3
2. 6
.0

59.7
72. 8
66.1
61. 5
73.3

19.5
14.0
27.6
35. 9
26. 7

20.8
13.1
6.5
7.7
.0

72.2
84.6
88.3
82.1
100.0

7.0
2.3
5.2
10.2
.0

20.8
13.1
6.5
5.1
6.7

72.2
84.3
87.9
84.6
93.3

7.0
2.6
5.6
10.3
.0

1 53.3
131.2
i 30.1
131.3
i 16.7

Total........................ 1,137

10. 5

69.0

20.5

10.6

85.4

4.0

10.6

85.0

4.4

1 31.9

1 Exclusive of those of Italian and Spanish descent.




54

DUST PHTH ISIS IN THE GRANITE-STONE INDUSTRY.

B riefly sum m arized, the an alysis shows th a t the inside s a n ita ry
conditions as to cleanliness were u n satisfacto ry or bad, as fo llo w s:
Houses of—
Per ceQtManufacturers and foremen...............................................................
0. 0
Draftsmen...............................................................................................
2. 5
Engineers, firemen, electricians, and machinists......................... 13. 0
Tool grinders and tool carriers.......................................................... 1 0 . 1
Polishers, bed setters, and sawyers................................................. 1 0 . 0
Lumpers, boxers, and derrick men.................................................. 14. 2
Tool sharpeners.................................................................................... 15. 4
Granite cutters..................................................................................... 2 0 . 5

The corresponding figures as to inside sanitary conditions with
reference to light and air were bad as follows:
Houses of—
Per cent.
Manufacturers and foremen................................................................. 0. 0
Draftsmen...................................................................................................... 0
Engineers, firemen, electricians, and machinists...........................4. 4
Tool grinders and tool carriers............................................................ 1. 3
Polishers, bed setters, and sawyers................................................... 3. 5
Lumpers, boxers, and derrick men................................................... 1. 4
Tool sharpeners............................................................................................0
Granite cutters....................................................................................... 4. 0

With reference to tuberculosis, the inside conditions as to light
and air are obviously of most importance, and the results of the
investigation indicate that on the whole these conditions, with the
exception of a small fraction of the houses, were sufficiently satisfac­
tory to justify the assumption that the inside environment was above
the normal for average wage earners in other sections or industrial
districts.
The outside sanitary conditions were unsatisfactory or bad, as
follows:
Houses of—
Per centManufacturers and foremen................................................................. 0. 0
Draftsmen......................................................................................................0
Engineers, firemen, electricians, and machinists...........................4. 4
Tool grinders and tool carriers............................................................ 1. 3
Polishers, bed setters, and sawyers................................................... 4. 2
Lumpers, boxers, and derrick men................................................... 1.1
Tool sharpeners........................................................................................... 0
Granite cutters....................................................................................... 4. 4

These statistics fully support the previous conclusion and justify
the statement as regards both inside and outside sanitary conditions
that the environment of persons employed in the Barre district is
unquestionably above the normal average of wage earners generally.
In connection with this survey an effort was made to ascertain the
tuberculosis history of the family, and, on the whole, no difficulty was
met with in securing an accurate and complete statement of the
facts. The record as it appears on the original blank (see p. 138)
shows the relation of the person affected with tuberculosis to the head
of the family, the sex, age, disease condition, or whether formerly a
patient. For present purposes it will be sufficient to indicate the
percentage of homes with tuberculosis in the family, but it must be
kept in mind that the record shows that granite cutters are suffering
from an extremely high death rate from the disease. The proportion
of homes with tuberculosis history in the family was as follows:




55

MORTALITY AMONG GRANITE-STONE WORKERS.
Per cent,
with
a
history of
tubercuNumber, losis.

Homes of—
Manufacturers and foremen.............................................
149
Draftsmen.............................................................................
40
Engineers, firemen, electricians, and machinists----23
Tool grinders and tool carriers........................................
79
Polishers, bed setters, and sawyers................................
199
Lumpers, boxers, and derrick men...............................
203
Tool sharpeners..................................................................
39
Granite cutters................................................................... 1,137

24. 8
30.0
30. 4
7. 6
25. 6
18. 7
35. 9
31. 9

In the case of some of the occupations referred to the numbers, of
course, are too small for an entirely safe conclusion, but the facts as to
the inside and outside sanitary conditions are summarized in Table
38, arranged according to the percentage of tuberculosis history in
the family for the different occupational groups. This table does not
seem to suggest that there is a very definite ascertainable relation
of a tuberculosis history to the inside or outside sanitary conditions
of the premises.
Table 3 8 .—PROPORTIONATE DISTRIBUTION OF M ANUFACTURERS AND EM PLOYEES
IN TH E GRANITE-CUTTING IN D U ST R Y OF B A R R E , V T ., ACCORDING TO HOME H Y ­
GIENIC CONDITIONS AND TUBERCULOSIS H ISTO R Y IN FAM ILY, AUGUST, 1919, B Y
OCCUPATION. GROUPS.

Outside sanitary
conditions.

Inside sanitary conditions.
Occupation group.

Num­
ber.

Cleanliness.

Light and air.
Good.

Good.

Tool sharpeners. ___
39
Cutters............................ 1,137
Engineers, firemen,
electricians, and ma­
chinists........................
23
Draftsmen......................
40
Polishers, bed setters,
and sawyers...............
199
Manufacturers and fore­
men .............................. 149
Lumpers, boxers, and
derrick men...............
203
Tool grinders and tool
carriers........................
79

Fair.

Bad.

Good.

Fair.

Fair.

Tuber­
culosis
history
in
Bad. family.

Bad.

P erct. P erct. Per ct. Per ct. Per ct. Perct. Per ct. Per ct. P erct. P erct.
15.4
25.6
74.4
0.0
61.5
23.1
23.1
76.9
0.0
35.9
10.6
85.4
10.5
69.0
20.5
4.0
10.6
85.0
4.4
31.9
26.1
55.0

60.9
42.5

13.0
2.5

30.4
60.0

65.2
40.0

4.4
.0

30.4
65.0

65.2
35.0

4.4
.0

30.4
30.0

15.1

74.9

10.0

14.1

82.4

3.5

18.3

77.5

4.2

25.6

57.0

43.0

.0

59.1

40.9

.0

57.7

42.3

.0

24.8

9.4

76.4

14.2

8.9

89.7

1.4

10.6

88.3

1.1

18.7

19.0

70.9

10.1

19.0

79.7

1.3

22.8

75.9

1.3

7.6

ABSENCE OF OVERCROWDING.

Table 39 shows the actual and proportionate distribution of work­
men according to occupational groups and room density, with com­
parative data as to overcrowding, on the basis of the English standard
of more than two persons in a room, correlated with the mortality
rate from pulmonary tuberculosis for the four principal occupational
groups sufficiently numerous to yield a satisfactory basis for arriving
at safe conclusions. This table also indicates no such pronounced
differences in room congestion as would seem to have a direct bearing
upon wide variations in the tuberculosis death rate, being indicative
rather, of an environment on the whole favorable to a low tubercu­
losis death rate, although as a matter of fact an excessive death rate
prevails in the case of at least two of the principal occupations in the
granite industry.




56

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

T ab le 3 9 .— ROOM ACCOMMODATION IN HOMES OF M ANUFACTURERS AND EM PLO YEES
IN GRANITE-CUTTING IN D U ST R Y OF B A R R E , V T ., AUGUST, 1919, B Y OCCUPATION
GROUPS.

Persons per
room.

Manufac­
Drafts­
turers
men.
and fore­
men.

Engi­
Polish­
neers,
Tool
firemen, grinders ers, bed
electri­ and tool setters,
saw­
cians,
carriers. and
yers.
and ma­
chinists.

Lump­
Tool
ers, box­
ers, and sharpen­
derrick
ers.
men.

Granite
cutters.

Total.

Per No. Per No. Per No. Per No. Per No. Per No. Per No. Per No. Per
No. cent.
cent.
cent.
cent.
cent.
cent.
cent.
cent.
cent.
0.10 U> 0 .2 5 ....
0.25 to 0 .5 0 ....
0,50to 0 .7 5 ....
0J5 to 1.00___
1,00 to 1 .2 5 ....
1.25 to 1.50___
1.50 to 1 .7 5 ....
1,75 to 2.00
2.00 to 2.25
2.25 to 2.50
2.50 to 2.75
2.75 to 3.00
3.00 to 3.25

1 0.7
38 25.5 “ *6 *i5.*0
66 44.3 18 45.0
26 17.4 12 30.0
14 9.4
3 7.5
1
1 2.5
.7
3 2.0

Total........

40 100.0

1 4.3
2 8.7
10 43.6
2 8.7
7 30.4
1

149jl00.0

Item.

Average number of persons
per room................................
Overcrowding1 (per cent)__
Death rate from pulmonary
tuberculosis per 100,000____

4.3

23 100.0

9
19
21
21
2
3
1
3

11.4
24.1
26.6
26.6
2.5
3.8
1.2
3.8

27
58
39
54
12
5
1
3

13.6
29.2
19.-6
27.1
6.0
2.5
.5
1.5

3
24
64
34
51
13
11
1
1

1.5
11.8
31.6
16.7
25.1
6.4
5.4
.5
.5

1

.5

79 100.0 199 100.0 203 100.0

8
11
9
10
1

20.5
28.2
23.1
25.6
2.6

5 0.4 10 . 0.5
67 5.9 181 9.7
303 26.6 549 29.4
263 23.1 406 21.7
372 32.7 532 28.4
73 6. 4 103 5.5
28 2.5 50 2.7
11 1.0 15
.8
12 1.1 19 1.0
1
.1
1
.1
1
.1
1
.1

1
.1
2i - 1
39 100.0 1,137 100.0 1869|1(XX0

Engi­
neers,
Polish­
fire­
Tool ers, bed Lump­
Manu­
factur­
men,
grind­ setters, ers,box­ Tool Granite
Drafts­
ers, and sharp­ cutters. Total.
ers and men. electri­ ers and
and
derrick eners.
fore­
cians, tool car­ saw­
men.
and
riers.
men.
yers.
machin­
ists.

0.67
.0

0.65
.0

0.76
.0

0.87
3.8

0.83
1.5
187.6

0.82
1.0
254.4

0.72
.0 *
339.4

0.87
1.3

0.83
1.2

949.6

1 On the basis of English standard of more than 2 persons per room.

The amount of overcrowding on the basis of the English standard
of more than two persons in a room was most pronounced in the case
of tool grinders and carriers and of granite cutters, and was relatively
high in the case of polishers, bed setters, and sawyers, although this
group shows a tuberculosis death rate very much lower than the
corresponding rates for tool sharpeners and granite cutters. In fact,
the investigation seems to justify the conclusion that on the whole
the housing conditions are not greatly at variance for different wageearning groups, and when compared with other housing surveys for
industrial sections the results are decidedly in favor of men employed
in the granite industry.
Comparing, for illustration, the room accommodation of granite
cutters in Barre, Vt., with the housing conditions of workmen in
Brooklyn and in the Chicago Stock Yards district, with a due regard
to racial elements, the results as shown in Table 40 are as follows:
The average number of persons to a room was 0.87 for the granite
cutters of Barre, against 1.49 for* Brooklyn workingmen’s families,
1.12 for the Slovaks and 1-.30 for the Lithuanians of the Chicago
Stock Yards district, and 1.29 for the Greeks and Italians in the




MORTALITY AMONG GRANITE-STONE WORKERS

57

vicinity of Hull House. The overcrowding on the basis of the Eng­
lish standard of more than two persons in a room was 1.3 per cent
for granite cutters, 24.2 per cent for Brooklyn workingmen’s
families, 14.6 per cent for the Slovaks, and 12.9 per cent for the
Lithuanians of the Chicago Stock Yards district, and 16.6 per cent
for Greeks and Italians in the vicinity of Hull House.
Table 4 0 __ ROOM ACCOMMODATION IN HOMES OF THE G R ANITE CUTTERS OF
B A R R E , V T ., COMPARED W IT H T H A T OF SELECTED GROUPS OF W O RK ING M EN
IN B R O O K L Y N AN D CHICAGO.
[Housing Standards in Brooklyn, by John C. Gebhart, 1918; Chicago housing conditions, V III, IX , and. X ,
by Wilson, Smith, Hughes, and Walker, in the American Journal of Sociology, Vols. X X and X X I.]
Chicago housing districts.
Persons per room.

0.10 to 0.25...........................................................
0.25 to 0.50...........................................................
0.50 to 0.75..........................................................
0.75to 1.00..........................................................
1.00 to 1.25..........................................................
1.25 to 1.50..........................................................
1.50tol.75..........................................................
1.75to2.00..........................................................
2.00 to 2.25..........................................................
2.26 to 2.50..........................................................
2.50 to 2.75..........................................................
2.75 to 3.00..........................................................
3.00 to 3.25............................... ..........................
3.25 to 3.50..........................................................
3.50 to 3.75..........................................................
3.75 to 4.00...........................................................
4.00 to 4.25...........................................................
4.25 to 4.50..........................................................
4.50 to 4.75...........................................................
4.75 to 5.00..........................................................
5.00 and over......................................................

Granite
cutters.

Per cent.
0.4
5.9
26.6
23.1
32.7
6.4
2.5
1.0
1.1
.1
.1

.1

Brooklyn
working­
men’s fami­ 20th ward
lies.
(Slovaks).

4th ward
(Lithua­
nians).-

Per cent.
0.1
.9
6.7
6. 5
20.2
16.7
17.2
7.5
11.1
5. 2
4.1
.5
1.8
.2
.5

Per cent.
0.6
2.2
11.6
9.0
25.3
16.0
17.3
3.5
8.6
2.2
2.1

Per cent.
0.2
1.8
10.1
9.4
19.2
19.4
18.0
9.0
8.2
2.4
1.7

1.4

.4
.1

.6

.1

.1

.1

Vicinity of
Hull House
(Greeks and
Italians).
Per cent.
0.3
3.5
12.8
8.5
22.9
13.1
17.0
5.3
8.6
3.7
2.3
.2
1.0
.1
.2
.3
.1

.1

.1

Total.............................................................

100.0

100.0

100. 0

100.0

100.0

Average number of persons per room..........
Overcrowding1 (per cent)..............................

0. 87
1.3

1.49
24.2

1.12
14.6

1.30
12.9

1. 29
16.6

.1

1 On the basis of English standard of more than 2 persons per room.

J‘ie foregoing observations are amplified by Table 41, illustrating
conditions of overcrowding in the principal cities of representative
stations of England and Wales, according to the census of 1911.
This table presents a really extraordinary contrast in that the range
of room density, as measured by the percentage of total population
Uv'ng more than two persons in a room, was from 39.8 per cent in
Finsbury metropolitan borough of London to 12.8 per cent in
th*i Darlington metropolitan borough of Durham, against only 1.3
per cent for the granite cutters of Barre, Yt.




58

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

T a b le 4 1 .—OVERCROW D IN G IN HOMES OF G R AN ITE CUTTERS A T B A R R E , V T . COM­
PARED W IT H THOSE OF “ PR IVATE F A M IL IE S " OCCUPYING TEN EM E NTS itf T H E
MORE CONGESTED M ETR O PO LITAN BOROUGHS, C O U N T Y BOROUGHS, AN D U R BAN
DISTRICTS OF MORE T H A N 50,000 IN H AB IT AN T S OF EN G LA N D A N D W A L E S .
ENG LAN D AND W A LE S , 1911.

Boroughs or districts.

Number of
persons living
more than two
in a room.

Finsbury metropolitan borough (London)...........................................
Shoreditch metropolitan borough (London)........................................
Stepney metropolitan borough (London)..............................................
Gateshead county borough (Durham)...................................................
Bethnal Green metropolitan borough (London).................................
South Shields county borough (Durham)........................................... .
Sunderland county borough (Durham).................................................
Newcastle-upon-Tyne, eity of, county borough (Northumberland)
Tynemouth county borough (Northumberland)............................... .
Southwark metropolitan borough ( London)........................................
Holborn metropolitan borough (London).............................................
St. Pancras metropolitan borough (London).......................................
Bermondsey metropolitan borough (London).....................................
Poplar metropolitan thorough (Lon<fon)............?.................................
Islington metropolitan borough ( London)............................................
Plymouth county borough ( Devonshire)............................................ .
Kensington metropolitan borough (London).......................................
St. Helens county oorough ( Lancashire)..............................................
West Hartlepool county oorough (Durham)...................................... .
Dewsbury metropolitan borough (Yorkshire, West Riding)...........
Devonport county borough (Devonshire).............................................
Paddington metropolitan borough (London)......................................
West Ham county borough ( Essex).......................................................
Dudley county borough ( Worcestershire)........................................... .
Chelsea metropolitan borough (London)............................................. .
Fulham metropolitan borough ( London).............................................
Hammersmith metropolitan borough (London).................................
Willesden urban district (Middlesex)................................................... .
Lambeth metropolitan borough (London).......................................... .
Camberwell metropolitan borough ( London).....................................
Middlesbrough county borough (Yorkshire, North Riding)...........
Battersea metropolitan borough (London).........................................
Wigan county borough ( Lancashire)....................................................
Westminster, city of, metropolitan borough (London)....................
Darlington metropolitan borough (Durham)......................................

Per cent of
total
population.

33, 917
39,127
92, 305
38, 716
41,152
34,998
48,125
81,141
17,167
46, 800
9,716
51, 214
28, 591
21,178
32,240
62, 789
18,565
26,681
16,018
10,537
8,646
11,058
20, 885
43,714
7, 591
8,832
21,784
16, 212
21,175
38, 816
34,174
13, 513
21,814
11, 297
16,596
6, 912

39.8
36.6
35.0
33.7
33.2
32.9
32.6
31.6
30.7
25.8
25.6
25.5
23.4
20.7
20.6
20.0
17.5
17.1
17.0
16.7
16.6
16.2
16.2
15.3
15.0
14.9
14.6
14.2
13.9
13.6
13.5
13.4
13.3
12.9
12.9
12.8

15

1.3

G R A N IT E -C U T T IN G IN D U S T R Y , B A R R E , V T .
Granite cutters.........................................................................................................

The available data would seem to leave no other conclusion than
that, aside from a more favorable physical condition, the granite
cutters of the Barre district live under home conditions decidedly
superior to those of wage-earners7families in the more congested cen­
ters of population. It would therefore seem to follow as a selfevident conclusion that the conditions predisposing to ill health and
shortness of life, particularly to the excessive incidence of tuberculous
or nontuberculous respiratory diseases, must be traceable to the in­
dustry in which the men are employed.
ABSENCE OF FAMILY INFECTION.

The relative frequency occurrence of tuberculosis in the families
of granite cutters naturally raises the important question of the danger
of infection. So much is included in what is still a serious matter
of controversy that it would not serve a practical purpose to enlarge
upon this subject at this time. The information collected during the
present inquiry is, however, of such exceptional value that all the
essential facts are presented in tabular form in Tables 42 to 45.




MORTALITY AMONG FAMILIES OF GRANITE CUTTERS.

59

The p ractical v alue of this inform ation w ill be b etter realized when a t­
tention is directed to the theoretical assum ption according to which
the ex trao rd in ary am ount of pulm o n ary tuberculosis am ong gran ite
cutters should h av e proved a fertile source of disease dissem ination
am ong other m em bers of th eir fam ilies. As a m atte r of fact, no
such dissem ination has taken place, and p a rtic u la rly not in the case
of g ran ite-c u tte rs’ w ives, for the relativ e frequen cy of p ulm onary
tuberculosis am ong them is considerably less th an th a t w hich would
be th eo retically assum ed to occur.
MORTALITY AMONG FAMILIES OF GRANITE CUTTERS.
FAMILY MORTALITY RECORDS OF GRANITE CUTTERS.

It has seemed advisable to consider very briefly in this connection
the occurrence of pulmonary tuberculosis among the families of
granite cutters, to determine, as far as this may be possible, the
extent to which the disease as met with in the granite industry is
unquestionably of an infectious character, or, conversely, the practical
certainty that the prevailing lung diseases are of a nontubercular
fibroid type erroneously diagnosed as tuberculous or of bacillary
origin. Theoretically, the disease should be met with in practically
the same proportions among the different members of granite-cutters'
families as among the granite cutters themselves, on the assumption
that through infection the disease is spread from one diseased adult
to another. The evidence available, however, would seem to prove
a relative infrequency of pulmonary tuberculosis, especially among
granite-cutters’ wives, who of all the members of the family are most
exposed to the risk of direct contact infection. It is not implied, of
course, that in many cases the diseases met with are not strictly
tuberculous or a type of superinduced tuberculosis upon a preexisting
pneumoconiosis. It is recognized that adult contact infection is of
itself less common than is generally assumed to be the case, but the
present investigation clearly emphasizes that the excessive frequency
of lung diseases among granite cutters is not shared among other
members of the families most exposed to the risk of contact infection.
The data upon which these conclusions are based represent a special
analysis of 18,406 deaths in the counties of Caledonia and Washington.
The names on these certificates were carefully checked one against
another and amplified, as far as practicable, by personal inquiry and
the local cemetery records. It is realized that while such an investiga­
tion has inherent limitations and that it, of course, can not be extended
to the entire family history of the persons concerned, it is the only
method available by which a fair approximation of the truth can be
arrived at. The data collected are presented in Tables 42 to 48,
showing the causes of death among different members of granitecutters’ families both prior and subsequent to the granite cutter’s
death from tuberculosis. In the tables the deaths of sisters are
excluded because of the fact that the names are too often lost sight of
through marriage. Table 42 clearly indicates that deaths from tuber­
culosis are comparatively rare among granito-cutters’ wives, but rela­
tively excessively common among granite-cutters’ brothers, who.
it may be assumed, also represent employments in the granite-cutting
61928°— 22— Bull. 293-------5




60

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

industry. The number of families for which it was possible to work
up a family mortality record and in which the head of the family died
from pulmonary tuberculosis during the period 1893-1919 was 162.
The total number of persons represented by these 162 families was 232.
Of this number, 20 wives died previous to the death of the granite
cutter from pulmonary tuberculosis, while 24 died subsequently.
Of the 20 prior deaths only 3 were from pulmonary tuberculosis,
while among the 24 subsequent deaths, 5 were from pulmonary
tuberculosis. Without attempting a refinement in analysis, it would
seem entirely safe to conclude that, considering the relatively large
exposure, the occurrence of death from tuberculosis among granitecutters7 wives is unquestionably belo^ what would be expected on
the probable degree of infectiousness in adult life. Similar conclu­
sions apply to daughters and mothers. The larger number of deaths
among sons, fathers, and brothers is in all probability directly attrib­
utable to their employment in the stone industry.
T a b le 4 2 .— F A M IL Y M O R T A L IT Y 1 OF G R A N IT E CUTTERS OF W A SH IN G TO N AND CALE­
DO NIA COUNTIES, V T ., W H O D IED FROM P U L M O N A R Y TUBERCULOSIS, 1893 TO 1919,
CLASSIFIED ACCORDING TO R E L A TIO N SH IP , CAUSE OF D E A T H , AND W H E T H E R
D E A T H W AS PR IOR OR SUBSEQ U EN T TO T H A T OF DECEASED C U T T ER .
[Based on records of families of 162 deceased cutters. Abbreviations: B .= brother; F .= father; S .= son;
M .= mother; D .= daughter; W .= wife.]

Prior deaths.

Abridged
inter­
national
list num­
ber.3

Subsequent deaths.

Cause of death.
B.

1
Typhoid fever..............................................
1
Influenza
...................................
Other epidemic diseases.............................
Tuberculosis of tb e lungs........................... 27
Tuberculous meningitis.............................
Other forms of tuberculosis.....................
1
Cancer and other malignant tumors.......
1
Simple meningitis.......................................
CereDral hemorrhage and softening.........
Organic diseases of the heart..................... 4
Acute bronchitis..........................................
Chronic bronchitis.......................................
Pneumonia..................................................
5
Other diseases of the respiratory sys­
tem (tuberculosis excepted).................. 2
Diseases of thestomach(cancer excepted)
Appendicitis and typhlitis........................
Hernia, intestinal obstruction..................
Cirrhosis of the liver...................................
1
Acute nephritis and Bright’ s disease----Noncancerous tumors and other diseases
of the female genital organs...................
Puerperal septicemia (puerperal fever,
peritonitis)................................................
Other puerperal accidents of pregnancy
and labor....................................................
Congenital debility and malformations. 1
Senility..........................................................
1
Violent deaths (suicide excepted)...........
Suicide...........................................................
3
Other diseases..............................................
Unknown or ill-defined diseases..............
2
All causes...........................................

50

F.

S.

M.

1
6

9

D. W . W . D.

3

1

3

1

1

2

3

5

2

1

4
1
2
2

*T

1
1

l

3

5

23

1

1
2

2
1

1

1

7

1
1
1
1

3

1

1

3

2
1

B.

5

1

1

3

F.

1
1

1
1
2
2

2

S.

1

1
1

3

M.

1
1
2

1

3

” i

1

2

1
1

i
1

1

1

2
1

1

3

19

14

14

6

6

2

20

21

7

1

1

1

1
5
1

7

9

12

50

1 Adults 15 years of age and over.
* Manual of the International List of Causes of Death, United States Bureau of the Census, Washington.
D . C., 1916.




MORTALITY AMONG FAMILIES OF GRANITE CUTTERS.

61

Family records were also obtained for 133 deceased stonecutters
who died from causes other than pulmonary tuberculosis during
the period 1893-1919 (Table 43). Among this group the total
number of deaths of other members of the family recorded was 151.
There were 20 prior deaths of wives and 18 subsequent deaths of
wives from all causes, and 3 deaths from pulmonary tuberculosis
among the former and 1 death among the latter. It would serve
no purpose to apply refined methods of statistical analysis to so
small a statistical basis of information, but, again, it is a safe infer­
ence that pulmonary tuberculosis is comparatively of about the
same degree of occurrence among the wives of granite cutters dying
from tuberculosis as among those who died from other causes.
Practically the same conclusions apply to other members of the
family.
T able 4 3 .—F A M IL Y M O R T A L IT Y i OF GRANITE CUTTERS OF W ASH IN G T O N AND
CALEDON IA COUNTIES, V T ., W H O D IE D FROM CAUSES O TH ER T H A N PU L M O N AR Y
TUBERCULOSIS, 1893 TO 1919, CLASSIFIED ACCORDING TO RELATIO N SH IP, CAUSE OF
D E A T H , AN D W H E T H E R D E A T H W AS PRIOR OR SU BSEQ U EN T TO T H A T OF
DECEASED CU TTER.
{Based on records of families of 133 deceased cutters. Abbreviations: B.=brother; F.=father; S.=son;
M.=mother; D„ = daughter; W.=»wife.]

(jause oi ueam.

tional list
number. 2
1
9
12
13
14
15
16
17
18
19
20
21
22
23
24
26
27
28
29
30
31
32
33
34
35
36
37
38

Subsequent deaths.

Prior deaths.

Abridged
B.
1
Typhoid fever..............................................
Influenza........................................................ 3
Other epidemic diseases............................
Tuberculosis of the lungs.......................... 14
Tuberculous meningitis.............................
Other forms of tuberculosis.......................
Cancer knd other malignant tumors.......
1
Simple meningitis.......................................
Cerebral hemorrhage and softening........
2
Organic diseases of the heart..................... 4
Acute bronchitis......... ................................
Chronic bronchitis.......................................
2
Pneumonia....................................................
Other diseases ol the respiratory system
(tuberculosis excepted)..........................
Diseases of the stomach (cancer ex­
cepted)............. ..........................................
1
Appendicitis and typhlitis........................
Hernia, intestinal obstruction..................
Cirrhosis of the liver...................................
Acute nephritis and Bright’s disease___
Noncancerous tumors and other diseases
of the female genital organs...................
Puerperal septicemia (puerperal fever,
peritonitis).................................................
Other puerperal accidents of pregnancy
and labor....................................................
Congenital debility and malformations
Senility..........................................................
3
Violent deaths (suicide excepted)...........
1
Suicide...........................................................
1
Other diseases............. .................................
1
Unknown or ill-defined diseases..............
All causes...............................................

34

F.

S.

2

2
1

M.

D. W . W .

1

2

3

3

1

1
2

1

1
2

1
1

1

3

1
2

1

....

1

1

S.

1

2

2
2
1

M.

3
1

1
1

D.

i*
l

2

F.

B.

2
2

13

2

2

2
2
1

"2
3

1

5

2

1

1
1
1
2*

1

1
1

2

1

4

3

11

3

20

18

1

6

1
1
1

10

26

i

7

1

7

9

1 Adults 15 years of age and over.
2 Manual of the International List of Causes of Death, United States Bureau of the Census. Washington.
J>. C., 1916.




62

DUST1 PH TH ISIS IN THE GRANITE-STONE INDUSTRY.
FAMILY MORTALITY RECORDS OF FARMERS.

It was found possible to ascertain in a similar manner the family
mortality record of 77 farmers, including 108 deaths of other mem­
bers of the family (Table 44). All these farmers died from tubercu­
losis, there having been 8 prior deaths of wives from all causes, and
15 subsequent deaths, with 1 death each from pulmonary tuber­
culosis. The data are insufficient for the purpose of a strictly
scientific conclusion, but it is safe conjecture that pulmonary tuber­
culosis is relatively not more common among the families oi granite
cutters, who are excessively subject to the disease, than among
farmers, who are subject only to a normal rate of incidence.
4 4 . — FAM ILY M O R T A L IT Y i OF FARM ERS OF W ASH IN G TO N AND CALED O N IA
COUNTIES. V T ., W H O DIED FROM PU L M O N AR Y TUBERCULOSIS, 1893 TO 1919, CLASSI­
FIED ACCORDING TO R ELATIONSH IP, CAUSE OF D E A T H , AND W H E T H E R D E A T H
W AS PRIOR OR SUBSEQUENT TO T H A T OF DECEASED FAR M ER .

T a b le

[Based on records of families of 77 deceased farmers. Abbreviations: B .= brother; F .= father; S.=son;
M .= mother; D .= daughter; W .= wife.]
Prior deaths.

Abridged
interna­
tional list
number.2

Subsequent deaths.

Cause of death.
B.

F.

Typhoid fever.........................................
Influenza..................................................
Other epidemic diseases.......................
Tuberculosis of the lungs.....................
Tuberculous meningitis........................
Other forms of tuberculosis.................
Cancer and other malignant tumors..
Simple meningitis.................................
Cerebral hemorrhage and softening...
Organic diseases oithe heart...............
Acute bronchitis.....................................
Chronic bronchitis.................................
Pneumonia..
Other diseases of the respiratory system
(tuberculosis excepted)..........................
Diseasesofthe stomach (cancer excepted
Apperidicitis and typhlitis........................
Hernia ? intestinal obstruction.................
Cirrhosis of the liver...................................
Acute nephritis and Bright’ s disease...
Noncanceroustumorsand other diseases
of the female genital organs..................
Puerperal septicemia (puerperal fever,
peritonitis)................................................
Other puerperal accidents of pregnancy
and labor.
Congenital debility and malformations.
Senility.........................................................
Violent deaths (suicide excepted).........
Suicide.........................................................
Other diseases............................................
Unknown or ill-defined diseases............
All causes.

S.

M.

D. W . W .

D.

M.

F.

B.

1
1
1
3

1
10

20

1 Adults 15 years of age and over.
a Manual of the International List of Causes of Death, United States Bureau of the Census, Washington,
D. C., 1916.

Finally, there is included the mortality record of 904 deceased farm­
ers who died from causes other than pulmonary tuberculosis. The
number of deaths of other members of the family among this group
was 1,204. It is shown in Table 45 that there were 212 prior deaths
of wives, with 11-deaths from pulmonary tuberculosis, and 285 sub­
sequent deaths of wives, with 4 deaths from pulmonary tuberculosis.
It is significant that the number of deaths from this disease among
brothers and fathers, both prior and subsequent, should have been




63

MORTALITY AMONG FAMILIES OF GRANITE CUTTERS

so much less proportionately than observed among deaths of male
relatives of granite cutters dying both from pulmonary tuberculosis
and from other causes. This disparity can only be explained on the
ground of occupational exposure. It may, of course, be objected
that the data for granite cutters are insufficient, especially when con­
trasted with the much larger exposure of nontuberculous farmers’
families, and the question may be raised that 5 subsequent deaths
of wives of tuberculous granite cutters from pulmonary tuberculosis,
among 24 deaths from all causes is a much higher proportion than the
4 deaths from this disease among the 285 subsequent deaths of wives
of nontuberculous farmers. It is not, of course, argued that deaths
from infection do not occur in adult life among wives whose hus­
bands have died of the disease, but if the risk of adult infection were
at all a serious phenomenon it is a practical certainty that the pro­
portion of infected wives dying from pulmonary tuberculosis would
have been much greater than has actually been the case. It is not
intended that any of the foregoing observations and conclusions
should be carried too far, but the material seemed too valuable to
be omitted from the present discussion. The method certainly
suggests practically infinite possibilities for the future, being indica­
tive of reasonably trustworthy results provided the analysis is made
with the requisite impartiality.
4 5 .-F A M I L Y M O R T AL IT Y i OF FARM ERS OF W ASH IN G T O N AND CALED O N IA
COUNTIES, V T ., W H O D IED FROM CAUSES O THER T H A N P U LM O N AR Y TU BERCU ­
LOSIS, 1893 TO 1919, CLASSIFIED ACCORDING TO R ELA TIO N SH IP, CAUSE OF D E A T H ,
AND W H E T H E R D EAT H W A S PRIOR OR SUBSEQUENT TO TH AT OF DECEASED
FARM ER.

T a b le

[Based on records of families of 904 deceased farmers. Abbreviations: B.=brother; F.=father; S.=son;
M.=mother; D.=daughter; W .=w ife.]
Prior deaths.

Abridged
Interna­
tiona llist

Cause of death.
B.

number.*
Typhoid fever..............................................
Influenza.......................................................
Other epidemic diseases............................
Tuberculosis of the lungs.....................
Tuberculous meningitis.............................
Other forms of tuberculosis......................
Cancer and other malignant tumors
Simple meningitis.......................................
Cerebral hemorrhage and softening........
Organic diseases of the heart....................
Acute bronchitis..........................................
Chronic bronchitis......................................
Pneumonia....................................................
Other diseases of the respiratory system
(tuberculosis excepted)..........................
Diseasesofthe stomach(cancer excepted)
Appendicitis and typhlitis......................
Hernia, intestinal obstruction..................
Cirrhosis of theliver...................................
Acute nephritis and Bright’s disease___
Noncancerous tumors and other dis­
eases of th ef emale genita 1organs...........
Puerperal septicemia (puerperal fever,
peritonitis)................................................
Other puerperal accidents of pregnancy
and labor...................................................
Congenital debility and malformations..
Senility..........................................................
Violent deaths (suicide excepted).........
Suicide...........................................................
Other diseases..............................................
Unknown or ill-defined diseases...............

F.

2
1

2
3
20

S.

4

2

6

7
2

26

4

9

5
2

1

1
1

1

1

1

13

2

4

All causes............................................. 185

53

3
*2*

1

8
7

10
3
1
12

D. W . W .

*’ i"
1 11
1

23
33
5

1
12
5
3
26
5

M.

Subsequent deaths.

3
5
1
2
10
1
1
1
1

1
5
3
1
5 '*6V
3
41

48

D.

M.

S.

1
1 "T
1
4
2
1

3
39
29
1
11
4
33 " l

3
” 5" 12
2
2
11
4
1
2
21 24

"T
27
*4' 35
1
5
26
l

8
4
3
5

14
5
1
5

2
3

10

12

1

1

1

1

1
32
2 "3
1
1
3 *26’ 47
2
1
5
3
1

12
2

34 212 285

21

F.

B.

1
3
1

1
1

....
....

5

3

2

2
17

3
7
2
1
5

4
5
1

7
3
1

22
33
4

4

3

12

5
1

1

5
2

1
2

1

2

1

1

1

5

4

16

6

2
5
12
1

3
1
1
7
1

19
6
1
44
7

39

56

37

193

7

1Adults 15 years of age and over.
s Manual of the International List of Causes of Death, United States Bureau of the Census. Washington,
D. C., 1916.




64

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

EVIDENCE CONCLUSIVE AS TO AN EXCESSIVE MORTALITY FROM DUST
PHTHISIS.

The general conclusions derived from these data would therefore
seem to support the theory that granite cutters in the State of
Vermont are subject to an excessive frequency of death from pul­
monary tuberculosis, not because of an exceptional risk of contact
infection, or because of inferior physique, or because of unfavorable
housing conditions or other sanitary deficiencies, but primarily
because of the occupational exposure, which in its final analysis is
reduced to the dust hazard resulting from the excessive use of pneu­
matic tools.
EVIDENCE INCONCLUSIVE AS TO CONTACT INFECTION.

To make the foregoing observations as useful as possible, three
additional tables are included, illustrating the family mortality of
granite manufacturers and cutters from principal causes, classified
according to the frequency of deaths from given causes during the
period 1893-1919. Table 46 shows the distribution of deaths by
causes, based on the records of 227 families of granite cutters and
manufacturers. These 227 families are represented by 543 deaths,
in 404 of which a given cause of death occurred once in a family, in
112 twice, and in 27 three or more times. Tuberculosis is the only
disease which shows a well-defined tendency to recurrence in the
same family. Considering the universal distribution of this disease,
its relative occurrence among granite-cutters’ families can not be
looked upon as abnormal, for against 93 families with only one death
from tuberculosis there were 42 with two deaths and only 7 with
three or more deaths.*2
a In this connection the following statement by Dr. Harry Le Barnes of the Vollum Lake Sanatorium,
R. I., on the incidence of tuberculosis of husbands and wives is of interest:
“ The histories of 229 consecutive widowed patients admitted to the Rhode Island State Sanatorium,
1905-1921, showed that 93, or 40 per cent, lost their consorts by death from tuberculosis, the tuberculosis
mortality being over three times that of the married people of the community.”
This statement would justify the conclusion that the type of lung disease called pulmonary tuberculosis
in the Barre district as it concerns granite workers is in all probability a nontuberculous form of dust
phthisis, frequently complicated in its terminal stage by a superinduced but less infectious type of true
tuberculosis.




65

MORTALITY AMONG FAMILIES OF GRANITE CUTTERS.

4 6 — F A M ILY M O R T A L IT Y 1 OF GRANITE M ANUFACTURERS A N D CUTTERS OF
W ASH IN G TO N AND CALEDONIA COUNTIES, V T ., FROM PRINCIPAL CAUSES, 1893 T O
1919, CLASSIFIED ACCORDING TO FRE Q U EN C Y OF DEATHS FROM G IVEN CAUSE.

T a b le

[Based on the records of 227 families.]
Famili es with one
death from given
cause.

Cause of death.

Families with two
deaths from giv­
en cause.

Families with three
or more deaths
from given cause.

Num­
ber of
families
Deaths
Deaths
Deaths
with no
of
of
of
deaths
granite
granite
granite
from
man­
man­
man­
given No. Deaths. ufac­ No. Deaths. ufac­ No. Deaths.
ufac­
cause.
turers
turers
turers
and
and
and
cutters.
cutters.
cutters.

Tuberculosis of the lungs.............
Pneumonia......................................
Organic diseases of the heart___
Bright’s disease..............................
Cerebral hemorrhage and ap­
oplexy ...........................................
Influenza.........................................
Cancer of the stomach and liver.
Tvphoid fever.................................
Senility............................................
Purulent infection and septi­
cemia .............................................
Angina pectoris.............................
Chronic bronchitis........................
Cancer of the peritoneum, intes­
tines, and rectum......................
Cancer of the female genital
organs............................................
Cancer of other organs..................
Traumatism by other crushing
(vehicles, etc.)............................
Alcoholism (acute or chronic)..
Diseases of the arteries, athe­
roma, etc......................................
Broncho-pneumonia.....................
Pulmonary congestion and pul­
monary apoplexy......................
Hernia and intestinal obstruc­
tion................................................
Cirrhosis of the liver......................
Suicide by firearms.......................
Diabetes..........................................
Acute endocarditis........................
Acute bronchitis............................
Appendicitis and typhlitis..........
Other diseases of the liver...........
Acute nephritis..............................
Accidental drowning....................
Homicide by firearms...................
All other causes.............................
Total......................................

85
171
194
198

93
52
31
25

93
52
31
25

81
30
9
11

42
3
2
4

84
6
4
8

59
2
2
2

207
207
218
220
220

20
18
7
7
7

20
18
7
7
7

4
8
3
3

2
2

4
4

4
3

221
221
221

6
6
6

6
6
6

2

222

5

5

2

222
222

5
5

5
5

2

222
223

5
4

5
4

3
2

223
223

4
4

4
4

2
1

223

4

4

3

223
223
223
224
224
224
224
224
224
224
224

4
4
4
3
3
3
3
3
3
3
3

4
4
4
3
3
3
3
3
3
3
3
54

2
1
1
2
1
16

2

1

404

197

112

73

7
1

24
3

15
1

27

16

3

4
1

i Adults 15 years of age and over.

In Table 47 it is shown that among 2,040 families representing
occupations other than granite cutters in Caledonia and Washington
Counties, Vt., there occurred 4,608 deaths, of which 4,034 were in
families in which 1 death from each given cause occurred, 534 in
families having 2 deaths from each given cause, and 40 in families
having 3 or more deaths from each given cause. Of the 534 deaths
occurring in families having 2 deaths from a given cause 116 were
from pulmonary tuberculosis, and in 40 families having 3 or more
deaths from a given cause there were 18 from pulmonary tuberculosis.
Here again an inference might seem justified that pulmonary tuber­
culosis is somewhat more common among granite-cutters7 families




DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

66

as the result of direct contact infection; but, taking all the facts into
consideration, the writer is inclined to think that the data do not
justify such a conclusion.
4 7 ___M O R T A L IT Y 1 FROM PRINCIPAL CAUSES IN FAMILIES OF W ASH IN G TO N
AND CALED ONIA COUNTIES, V T ., 1893 TO 1919, O T H E R T H A N THOSE OF GRANITE
M AN UFAC TUR ER S AND CU T T E R S, CLASSIFIED ACCORDING TO FR E Q U EN C Y OF
DEATH S FROM GIVEN CAUSE.

T a b le

[Based on records of 2,040 families.]

Cause of death.

Tuberculosis of the lungs........................................... .
Tneumonia.................................................................... .
Organic diseases'of the heart..................................... .
Bright’s disease..............................................................
Cerebralhemorrhage and apoplexy..........................
Influenza........................................................................ .
Cancer of the stomach and liver............................... .
Typhoid fever................................................................
Senility............................................................................
Purulent infection and septicemia............................
Angina peotoris..............................................................
Chronic bronchitis.........................................................
Cancer of the peritoneum, intestines, and rectum..
Cancer of the female genital organs...........................
Cancer of other organs................................................ .
Traumatism by other crushing (vehicles, etc.) —
Alcoholism (acute or chronic)................................... .
Diseases of the arteries, atheroma, etc.................... .
Broncho-pneumonia.....................................................
Pulmonary congestion and pulmonary apoplexy.
Hernia and intestinal obstruction.............................
Cirrhosis of the liver.....................................................
Suicide by firearms.......................................................
Diabetes......................................................................... .
Acute endocarditis...................................................... .
Acute bronchitis............................................................
Appendicitis and typhlitis........................................ .
Other diseases of the liver...........................................
Acute nephritis..............................................................
Accidental drowning....................................................
Homicide by firearms................................................ .
Allother causes.............................................................
Total..

Number Families with Families with FamiLes with
one death
two deaths three or more
of fami­
from given
from given
deaths from
lies with
cause.
given cause.
cause.
no deaths
from
given
cause.
No. Deaths. No. Deaihs. No. Deaths
277
407
471
266
375
95
104
41

221

17
65
52
26
34
77
28
12
126
71
52
35
17
19
38
12
35
21
23
21
11
1

277
407
471
266
375
95
104
41

221

116.

112
100

18
7

36
66
8
14
6
22

17
65
52
26
34
77
28
12
126
71
52
35
17
19
38
12
35
21
23
21
11
1
984

4,034

* Adults 15 years of age and over.

Table 46 includes the additional information of the deaths of granite
cutters and manufacturers, extracted from the family mortality so
as to make possible a more strict comparison with deaths of members
of the family without reference to the heads of such families. The
importance of this is more clearly indicated in Table 48, which gives
the proportionate distribution of deaths. Possibly more extended
consideration should have been given to this point, for of course the
influence of the heavy mortality of granite cutters themselves on the
aggregate family mortality is very serious.




67

MORTALITY AMONG FAMILIES OF GRANITE CUTTERS.

T a b le 4 8 .—F A M ILY M O R T A L IT Y i OF GR ANITE M AN U FAC TU R ER S AN D CUTTERS
FROM PRINCIPAL CAUSES COMPARED W IT H T H A T OF A L L O TH ER FAMILIES OF
W ASHING TON AN D C ALED O N IA COUNTIES, V T ., 1893 TO 1919.
[Based on records of 227 families of granite manufacturers and cutters and 2,040 families of others.]

Cause of death.

No deaths from given
cause.

One death from given
cause.

Two or more deaths
from given cause.

F a m ilies o.f
granite man­
u factu rers
and cutters.

F a m ilies of
granite man­
ufactu rers
and cutters.

F am ilies of
granite man­
ufactu rers
and cutters.

In­
cluding
manu­
factur­
ers and
cutters.

Tuberculosis of the lungs----Pneumonia................................
Organic diseases of the heart.
Bright’ s disease........................
Cerebral hemorrhage and
apoplexy................................
Influenza...................................
Cancer of the stomach and
liver.........................................
Typhoid fever..........................
Senility......................................
Purulent infection and septi­
cemia.......................................
Angina pectoris......... ..............
Chronic bronchitis...................
Cancer of the peritoneum,
intestines, and rectum........
Cancer of the female genital
organs.....................................
Cancer of other organs...........
Traumatism by other crush­
ing (vehicles, etc.)...............
Alcoholism (acute or chronic)
Diseases of the arteries, athe­
.................
roma, etc.. .
Broncho-pneumonia...............
Pulmonary congestion and
pulmonary apoplexy..........
Hernia ana intestinal ob­
struction
.............
Cirrhosis of the liver
Suicide by firearms.................
Diabetes
.................
Acute endocarditis..................
Acute bronchitis......................
Appendicitis and typhilitis..
Other diseases of the liver—
Acute nephritis
.............
Accidental drowning
Homicide by firearms

All
other
Ex­
Ex­
fami­ • In­
cluding lies. cluding cluding
manu­
manu­ manu­
factur­
factur­ factur­
ers and
ers and ers and
cutters.
cutters. cutters.

All
other
fami­
In­
lies. cluding
manu­
factur­
ers and
cutters.

All
oiher
Ex­
famicluding hes.
manu­
factur­
ers and
cutters.

Per cl.
37.4
75.3
85.5
87.2

Per ct.
80.6
89.0
90.3
92.1

Per ct.
83.3
77.2
74.3
86.1

Per ct.
41.0
22.9
13.6
11.0

P er ct.
18.1
10.1
9.7
7.0

P er ct.
13.6
20.0
23.1
13.0

P er ct.
21.6
1.8
.9
1.8

91.2
91.2

93.0
96.5

79.9
95.1

8.8
7.9

7.0
3 5

18.4
4.7

.9

96.0
96.9
96.9

97.8
98.2
96.9

94.6
97.9
88.7

3.1
3.1
3.1

2.2
1.8
3.1

5.1
2.0
10 8

97.4
97.4
98.7

98.2
97.4
98.7

99.1
96.7
97.4

2.6
2.6
2.6

1.8
2.6
1.3

.8
3.2
2.5

97.8

98.7

98.7

2.2

1.3

1.3

97.8
97.8

97.8
98.7

98.3
96.1

2.2
2.2

2.2
1.3

1.7
3.8

97.8
98.2

99.1
99.1

98.5
99.4

2.2
1.8

.9
.9

1.4
.6

.1

98.2
98.2

99.1
98.7

93.7
96.5

1.8
1.8

.9
1.3

6.2
3.4

.1
.1
.1

98.2

99.6

97.4

1.8

.4

2.5

98.2
98. 2
98.2
98.7
98.7
98.7
98. 7
98.7
98. 7
98. 7
98.7

98.2
98. 2
100.0
98.7
99.1
98.7
99.6
99.1
99.1
99.6
99.1

98.3
99.1
99.1
98.0
99.4
98.2
99.0
98.9
99.0
99. 4
99.9

1.8
1. 8
1.8
1.3
1.3
1.3
1.3
1.3
1.3
1.3
1.3

1.8
1.8

1.7
s
.9
1.9
.6
1.7
1.0
1.1
1.0
.5
.1

1.3
.9
1.3
.4
.9
.9
.4
.9

.9

P er ct.
1.3
.9
.9

P er ct.
3.1
2.8
2.6
.9
1.7
.2
3
.1
.5
.1
.1
.1

.1

.l
.1
.1

.1

1
1 Adults 15 years of age and over.

Excluding manufacturers and cutters, it is shown tiiat among
granite-cutters* families no tuberculosis occurred in 80.6 per cent of
all the families considered, against 83.3 per cent for nongranitecutters’ families, as dealt with in greater detail in Table 47. The
disease occurred once among 18.1 per cent of granite-cutters’ families
as against 13.6 per cent for all other families, and it occurred twice or
more in the proportion of 1.3 per cent for granite-cutters’ families
to 3.1 per cent for all other families. .This really sustains the con­
clusion, previously advanced, that the frequency of pulmonary tuber­
culosis among immediate relatives of granite cutters, but particu-




68

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

larly wives, daughters, and mothers, is much less than as a mere
matter of probability would be assumed to be the case.
Inquiry was made as to the mortality from pulmonary tuberculosis
among the families of living granite workers and it was found that
of a total of 1,869 granite workers interviewed, 312 gave positive
tuberculosis histories in their families. The distribution of the mem­
bers of the families who had died from the disease was as follows:
T able 4 9 .—M O R T AL IT Y FROM PU LM O N AR Y TUBERCULOSIS IN THE FAMILIES OF
LIVING GR ANITE W O R K E R S OF B A R R E , V T ., AUGUST, 1919, CLASSIFIED ACCORD­
ING TO AGE A T D E A T H , AN D R ELATION SH IP TO THE GRANITE W O R K E R S, OF
THE DECEASED MALES.

Deceased males.
Age at death.

Fath­
Broth­
Uncles. ers.
ers.

10 to 19 years............................
20 to 29 years............................
30 to 39 years............................
40 to 49 years............................
50 to 59 years............................
6 0 1o 69 years............................
70 to 79 years............................
80 to 89 years............................

Brothers-inlaw.

Cous­
ins.

Fathers-inlaw.

Grand­
fath­
ers.

1

8
25
17
30
22
3

2
6
17
14
7
1

1
2
21
31
20
1

4
3
5
2
1

Sons.

5
8

2

3
3
1
1
2

1

2
1
1
2

Total.

14
40
28
80
73
34
5
2

Total............................i . . .

105

47

76

15

4

10

4

15

276

Average age..............................

37.9

48.0

53.3

39.2

42.5

59.6

66.5

24.6

44.5

Deceased females.
Age at death.
Sisters- Moth­
Aunts. Sisters. in-law.
ers.

10 to 19 years.............
20 to 29 years............
30 to 39 years.............
40 to 49 vears............
50 to 59 years............
60 to 69 years............
70 to 79 years............
80 to 89 years............

4
5
4
2

1
4
1
1

4
26
5
6
1
1

2
10
3
4

Cous­
ins.

Grand­ Daugh­
Moth­
Total.
ers-in- Wives. moth­
ters.
ers.
law.

2
1

5
2
3
2
2

1

1
1
1
2
1
3
2
1

8
39
23
20
12
8
3
1

Total...................

15

43

7

20

3

5

9

10

2

114

Average age...............

45.1

28.3

26.6

39.8

17.0

49.8

34.7

59.6

22.0

36.2

The occupations which had been followed by the deceased males
were as follows:
T a b le

5 0 .—DISTRIBUTION

Occupations.

OF DECEASED M ALES B Y

Broth­
Broth­
Uncles. Fathers. ers-iners.
law.

OCCUPATION.

Cous­ Fathers- Grand­
in-law. fathers.
ins.

Sons.

Total.

Granite cutters........................
Farmers.....................................
All other occupations.............

54
4
47

23
4
20

56
3
17

8
1
6

2

5

2

5

1
2
1

10

154
14
108

Total...................................

105

47

76

15

4

10

4

15

276




5

69

TRADE LIFE AND OCCUPATIONAL CHANGES.

TRADE LIFE AND OCCUPATIONAL CHANGES.
OCCUPATION THE PRIMARY CAUSATIVE FACTOR OF EXCESSIVE
TUBERCULOSIS MORTALITY.

Evidently the principal underlying conditions responsible for the
excessive amount of mortality from lung disease in granite cutting
are occupational. It is therefore necessary to inquire with excep­
tional thoroughness into matters concerning trade life and occupa­
tional changes, as to which the available information for other
trades is extremely limited. In the present investigation it has
been found possible to ascertain facts of the first importance, em­
phasizing circumstances which unquestionably bear upon the larger
question of disease predisposition and relative frequency. With
these data of comparable value there are included some correspond­
ing statistics for limestone workers in southern Indiana as repre­
senting a branch of the stone industry subject unquestionably to
quite a different occupational hazard. The first question which
requires consideration is the extent to which previous employments
may possibly modify the risk inherent in the granite-cutting industry.
Information as to such previous employments has been obtained by
personal inquiry for many occupations, but for practical reasons the
tabular analysis is limited to 50 of the most important. The details
of the investigation are given in Table 51, according to which the pre­
vious occupation of granite cutters was chiefly marble cutting or farm­
ing. This is followed by tool grinding and drilling in granite quarries.
None of the other occupations are of sufficient numerical importance
to bear directly upon the question at issue. The average length of
previous employment in marble cutting was nine y^ars and in
farming eight years. This is reduced to only two years in tool
grinding and 3.4 years in drilling.
5 1 .—DISTRIBUTION OF W O R K E R S IN GRANITE-CUTTING IN D U S T R Y IN
B A R R E , V T ., AUGUST, 1919, ACCORDING TO TH E 50 MOST IM PO R TANT PREVIOUS
OCCUPATIONS.

T a b le

Workers other than
granite cutters.

Granite cutters.

Previous occupations.
Per cent.

Marble cutters..........................................................................
Farmers......................................................................................
Tool grinders, granite industry............................................
Granite cutters.........................................................................
Drillers, granite quarries........................................................
Messengers.................................................................................
Clerks..........................................................................................
Grocers and butchers..............................................................
Masons and bricklayers..........................................................
LumperSj granite industry...................................................
Tool carriers, granite industry..............................................
Mechanics and machinists.....................................................
Carpenters.................................................................................
Blacksmiths, general..............................................................
Teamsters..................................................................................
Bakers........................................................................................
Woodchoppers.........................................................................
Derrick men, granite industry..............................................
Granite polishers......................................................................
Sailors.........................................................................................
Painters............ .....
ff
, , , ...................




Average
period of
employ­
ment
(years).

31.6
20. 0
6.9

9. 0
8. 0
2.0

2. 8
2. 0
1. 8
1. 7
1. 7
1.7
1. 4
1. 3
1.2
1.2
1.1
.8
.7
.7
.6
.6
.5

3. 4
2. 2
2. 4
3. 4
7. 7
1. 8
2. 0
3. 2
5.0
4.1
3. 3
3. 3
5.7
1.9
4. 7
5. 1
2.8

Per cent.

7. 5
35.1
12. 2
15. 3
4. 8
1. 5
4, 7
1. 8
2. 5
6.1
1. 5
3. 6
1. 2
2.5
5. 5
1.1
2. 3
2. 2
3.1
1.2
.5

Average
period of
employ­
ment
(years).
9.5
10.5
2.0
15.4
6.8
1.5
2.4
3.6
9.4
6. 2
3.0
4. 2
6.1
8.7
5. 3
5. 9
5. 2
4. 0
6. 4
8.4
8.4

70

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

5 1 .—D IST R IB U T IO N OF W O R K E R S IN G R AN ITE-CU TTIN G IN D U S T R Y IN
B A R R E , V T ., A U G U ST , 1919, ACCORDING TO THE 50 MOST IM PO R TA N T PREVIO U S
OCCUPATIONS—Concluded.

T a b le

Worders other than
granite cutters.

Granite cutters.

Previous occupations.
Percent.

Average
period of
employ­
ment
(years).

Per cent.

Average
period of
employ­
ment
(years).

Rivet heaters............................................................................
Ropemakers..............................................................................
Section men, railway..............................................................
Shoemakers...............................................................................
Weavers, cotton mills.............................................................
Brakemen, railwav..................................................................
Paving-stone cutters...............................................................
Liquor dealers and bartenders.............................................
Tailors........................................................................................
Carders, woDlen mills..............................................................
Comb makers...........................................................................
Draftsmen, granite industry.................................................
Locomotive firemen................................................................
Freight agents..........................................................................
Mail carriers..............................................................................
Miners, copper
Miners, iron......... ....................................................................
Miners, coal...............................................................................
Plumbers...................................................................................
Spinners, cotton m ills ................................................; ........................
Sandstone cutters....................................................................
Hoisting engineers, granite quarries...................................
Boiler makers...........................................................................
Finishers, cotton m ills .........................................................................
Tool sharpeners, granite industry........................................
Coachmen................ •................................................................
Druggists....................................................................................
All other occupations1...........................................................

0. 4
.4
.4
.4
.4
.4
.4
.4
.4
.3
.3
.3
.3
.2
.2
.2
.2
.2
.2
.2
.2

3.6
3.6
3.3
.5
1. 4
2.0
1.8
4. 8
5.1
1. 8
6. 3
1. 9
6. 3
3. 0
1.5
4. 0
1. 3
2. 5
2. 0
.6
4.0

.2
.2
.1
1
.1
1
1
1
1
7.2

2.8
2.2
6.0
10. 0
1. 5
2. 3
2.0
1.6
3.1
2.9

15. 4

5.0

All previous occupations 1..............................................

2 73.3

6.0

2 82.9

7.1

Weavers, woolen m ills...........................................................

..........................................

.
.
.
.
.

0.4
1.4
.7
1. 4
.4

3.8
2.4
3. 4
2.0
2.0

3.6

4.6

1.2
.4

2.6
3.7

.4

7.3

.8
.7
.7
.5
7
.4
.4
.8

.

7. 3
3. 4
5.9
8.2
4. 2
8. 8
4.0
7.2

.5
.7
.5

4.0
3 4
5.5

.5
.4

1. 0
1.7

1 Exclusive of granite cutting.
2 These percentages are less than the sums of the percentages in the columns immediately above, for
the reason that multiple employments are involved.

Workers other than granite cutters in the granite industry lead
in farming as the previous occupation, followed, however, by granite
cutting and tool grinding in the granite industry, while marble cut­
ting is the fourth most important previous occupation. Among
granite cutters 31.6 per cent of the men had previously been employed
in marble cutting, with an average duration of employment of nine
years. The proportion for other workers in the granite industry was
only 7.5 per cent, with an average duration of employment of 9.5
years.
In the case of granite cutters the previous employment at farming
is represented by 20 per cent of the workers, with an average duration
of eight years. Farming is represented by 35.1 per cent for
other workers in the granite industry with an average duration of
10.5 years.




TRADE LIFE AND OCCUPATIONAL CHANGES.

71

ABSENCE OF PREVIOUS OCCUPATIONAL PREDISPOSITION.

In view of the facts that marble cutting, as a matter of practical
certainty, involves a much lesser degree of predisposition to lung
disease than granite cutting and that farming, broadly speaking, is
one of the healthiest of outdoor employments, it is clear that the
previous occupational conditions were not such as to predispose
.exceptionally to pulmonary tuberculosis. In the case of granite
cutters 73.3 per cent had followed some previous occupation and for
an average period of six years. In the case of other employees in the
granite-cutting industry 82.9 per cent had followed some previous
employment, of an average duration of 7.1 years. Thus the fore­
going analysis (given in more detail in Table 52 for the different
branches of the granite-cutting industry), illustrating wide variations
in previous occupational conditions, would certainly seem deserving
of extended consideration in arriving at definite conclusions con­
cerning other dangerous trades.
T a b le

5 2 .—OCCUPATIONAL H IS T O R Y OF W O R K E R S IN G R AN ITE-CU TTIN G INDUS­
T R Y IN B A R R E , V T ., AU G U ST , 1919.
Previous occupation.
Per cent of workers pre­
viously employed as—

Average period of em­
ployment (years).

Present occupation.
Stone
cut­
ters. 1

Tool sharpeners...............................
Granite cutters.................................
Polishers...................................
Manufacturers..................................
Engineers 4........................................
Lumpers............................................
Boxers................................................
Draftsmen.........................................
Foremen............................................
Sawyers..............................................
Derrick men.....................................
Bed setters........................................
Tool grinders....................................
Tool carriers . .
.................

5.1
3 32. 0
9. 5
80. 2
13. 0
16. 8
20. 0
7. 5
80. 0

Average......................................

29.5

12. 2
8. 3
13. 7

Present occupation.

All
Stone
Farm­ other
cut­
occupa­ ters. 1
ers.
tions. 2
15.4
20. 0
48. 2
28. 8
47. 8
49. 6
37.2
2. 5
12.5
64. 3
22. 5
62. 5
17. 8
16. 7

64.2
43. 0
87. 8
60. 4
73. 9
90. 8
94. 0
47. 5
92.5
92.9
93. 9
95. 8
32. 9
66. 7

13.7
3 8.9
4.5
19. 4
6.3
10. 4
8.3
11. 5
17.4

25.9

56.0

11.2

6.2"
7.3
21.6

Average
period of Average
employ­ present
All
ment
age.
Farm­ other
ers. occupa­ (years).
tions. 2
8.0
8.0
10.4
8. 5
9.5
11.3
11.5
7.0
7.7
15.6
10.1
11.8
9.2
.5

5.3
3.1
4. 5
5. 2
5.2
5. 5
4. 9
2.7
3.0
4.9
3.4
4.6
4.9
.7

21.0
17. 7
17.3
15. 7
14. 5
10. 7
7. 9
7. 4
7.1
6. 8
6.6
6.4
2.4
.9

41.8
37.4
41.4
43.4
41.7
38.1
36. 2
28. 5
37.2
36.0
30.4
34.4
23.3
22.8

9.3

3.9

15.2

37.2

1 Granite, limestone, marble, sandstone, slate, and talc.
3 Exclusive of present occupation.
8 Exclusive of granite cutting.
* Inclusive of engineers, firemen, electricians, and machinists.

For all granite workers the average duration of employment in the
occupation now followed was 15.2 years, while the attained average age
was 37.2 years, b.ut for the granite cutters alone the average period of
employment in the present occupation was 17. 7 years, while the aver­
age attained age was 37.4 years. These figures, combined with those
given in Table 51, give a full account of preoccupational conditions,
the wide variations of which clearly illustrate the doubtful nature of
conclusions based on general statistics, disregarding previous employ­
ments. To facilitate the study of this important aspect of trade life
in its relation to mortality, Table 53 is included, which gives in detail
the years of employment in the specific occupation followed for all
the essential branches of the granite-cutting industry and the number
of men employed in a stated number of previous occupations,




DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

72

T ab le 5 3 .—D ISTRIBUTIO N OF M ANUFAC TU R ER S AN D EM PLOYEES IN THE G R AN ­
ITE-CUTTING IN D U ST R Y OF B A R R E , V T ., AUG UST, 1919, B Y Y E A R S OF EM PLO Y­
M ENT IN PRESENT OCCUPATION AND NU M BER OF PREVIOUS OCCUPATIONS.
G R A N IT E C U T T E R S .
N tim ber of p reviou s occupations.

Present employment.

Total.
None.

One.

Two.

5
34
26
63
59
39
35
28
9
4
1
1

47
119
148
na
86
58
43
12
7
3
2

20
13
14
25
23
29
9
4
1
1
1

Three. Four.

Five.

Six.

Number.

PERIOD.
0 to 4 years...................................................
5 to 9 years...................................................
10 to 14 years...............................................
15 to 19 years................................................
20 to 24 years................................................
25 to 29 years...............................................
30 to 34 years................................................
35 to 33 years...............................................
40 to 44 years................................................
45 to 49 years ............................................
50 to 54 years...............................................
55 to 59 years...............................................

2

18
3
5
3
9
5
2

1
1
2
1

1
1

1

92
1®
104
205
179
IS
92
44
•17
8
4
1

304

638

140

45

7

2

1

1,137

Per cent of grand total..............................
Average period of present employment (years).

26. 7
21.6

.56. 1
16.4

12. 3
16. 7

4. 0
13.4

0.6

0. 2

0. 1

100.0
17.7

0 to 4 years___
5 to 9 years—
10 to 14 years..
15 to 19 years,.
20 to 24 years..
25 to 29 years..
30 to 34 years..
35 to 39 years..
40 to 44 years..
45 to 49 years..
50 to 54 years..
55 to 59 ^

1.6
11. 2
8. 7
20.7
19. 4
12. 8
11.5
9,2
3. 0
1. 3
.3
.3

7. 4
18. 7
23v 2
17.6
13. 5
9. 1
6.7
1.9
1.1
.5
.3

14. 3
9. 3
10. 0
17. 9
16. 4
20,7
6.4
2.9
.7
.7
.7

40. 0
6. 7
11. 1
6. 7
20. 0
11. 1
4. 4

14. 3
14. 3
28. 6
14.3

50. 0
50. 0

100.0

100.0

100.0

100.0

100.0

100. 0

100.0

100.0

100.0

1

32
13
15
13
16
21
21
5
3

Total......................................................

Per cent.
28. 5

8.1
14.9
17.0
18.0
15.7
11.6
S.l
3.9
1.5
.7
.4
.1

GRAN ITE POLISHERS.
Number.

PERIOD.

1
2
2
1
3
4
2
1
1

12
5
6
7
6
8
13
2
1

11
2
3
5
4
4
4
2
1

6
3
3

1
1
1

3
3
1

1
1

0 to 4 years................ .............. ..............................
5 to 9 vears.................... - ........................................
10 to 14 years.........................................................,
15 to 19 years..........................................................
20 to 24 years..........................................................
25 to 29 years...........................................................
30 to 34 years...........................................................
35 to 39 years..........................................................
40 to 44 years..........................................................
45 to 49 years..........................................................
50 to 54 years..........................................................
55 to 59 years..........................................................
Total.................................................................

17

60

36

19

5

1

1

139

Per cent of grand total.........................................
Average period of present employment (years).

12. 2
21.6

43. 2
1& 4

25. 9
15.9

13. 7
13.2

3.6

0. 7

0. 7

100.0
17.3

5. 9
11. 8
11. 8
5. 9
17.6
23. 4
11. 8
5. 9
5.9

20. 0
8. 3
ia o
11. 7
10. 0
13. 3
21. 7
3.3
1.7 :

30. 6
5. 6
8. 3
13. 8
IL 1
1L 1
11. 1
a 6
2.8

31. 5
20. 0
15. 8 : 20. 0
15. 8
20. 0

100.0

23.0
9.4
10.8
9.4
11.5
15.1
15.1
3.6
2.2

m o

: m o

Per cent.

PERIOD.

0 to 4 years............................................ ............ . . .
5 to 9 years.............................................................;
10 to 14 years.... ................................................... ..
15 to 19 years.... . , .....................................
20 to 24 years........................... ................... .......
25 to 29 years................................. .........................
30 to 34 years
.........................................
35to3&years
____ . . . .
40 to 44 years
.
.................

Total




-

1

...............................

100. 0

100. 0

100.0

15. 8
15. 8
5. 3

m o

20. 0
20.0

m o

100. 0

100.0

73

TRADE LIFE ANI> OCCUPATIONAL CHANGES*

T able 5 3 .—DISTRIBUTION OF M ANU FACTU RERS AND EM PLO YEES IN T H E G R A N ITECUTTING IN D U ST R Y OF B A R R E . V T ., AU G U ST. 1919, B Y Y E A R S OF EM PLOYM ENT
IN PRESENT OCCUPATION AN D N U M BER OF PR EVIO U S OCCUPATIONS—Continued.
M AN U FAC TU R ER S M B

FOREMEN.

Number of previous occupations.
Total.

Present employment.
None.

One.

Two.

9
7
10
9
10

13
16
12
7
5
5
1

Three. Four.

Five.

Six.

Number.
PERIOD.

2
1
1

8

6

2
4
3
1
1

4
4
2
1

1
1

2

1
1

61

29
33
29
18
16
16
7
1
1

11

1

1

150

7.3
0.7
40.7
39.3
8.7
2.7
11.4
17.1
11.5
6.3
Average13.8
period of
present
engagement
(years).

0.7

100.0
13.4

100.0

19.3
21.9
19.3
12.0
10.7
10.7
4.7

100.0

100.0

Total.................................................................

4

59

13

Per cent.

PERIOD.

0 to 4 years...........................................................
5 to 9 years..................................................... .
.

25 to 29 years...................................................
30to 34 years............................................
36 to 39 years................................................
49 to-44 years...................................................
4crto 49 years............. .................................
50 to 54 years................................................
55 to 59 years..................................................
T o ta l...............................................................

14.8
11.5
50.0
25.0 , 16.4
14.8
16.4
25.0 ; 13.1
9.8

22.0
27.1
20.3
11.9
8.5
8.5
1.7

15.4
30.7
23.1
7.7
7.7
15.4

36.4
36.4
18.1
9.1

100.0

100.0

100.0

100.0

100.0

1.6
1.6

m o

100.0

TOOL SHARPENERS.
Number.
PERIOD.

Oto 4 years............................................ .................
5 to 9 years............................................ .................
10 to 14 years...........................................................
15 to 19 years.......................................................
20 to 24 years................................................
25 to 29 years...... ..................................
30 to 34 years.....................................
35t o 39 years................ ......................................
40 to 44 years.....................................................
45 to 49 years.........................................................
50 to 54 years........................................
55 to 59 years...........................................................
Total.................................................................
Per cent of grand total.........................................
Average period of present employment (years).

1

1

14

16

4

4

35.8
41.0
22.9 : 21.2

10.3
19.8

10.3
12.4

1
1
1
1

Oto 4 years........ ......................................................
5 to 9 years..............................................................
7.1
10 to 14 years...........................................................
7.1
15 to 19 years........................................................... 21.5
20 to 24 years.......................................... ................. 21.5
25 to 29 years..........................................................
14.3
30 to 34 years........................................................... 21.4
35 to 39 years...........................................................
40 to 44 years...........................................................
7.1
45 to 49-years.......................................... ................
50 to 54 years...........................................................
55 to 591years...........................................................
Total................................................................ 100.0

1

1

1
2 .6

4
2
4
6
7
5
8
1
2

39
100.0
21.0

Per cent.

PERIOD.




2

1
1
3
2
3
2
2
1
1

1
1
3
3
2
3

6.3
6.3
18.7
12. &
18.6
12. 5
12. 5
6.3
6.3

100.0

25.0

50.0
25.0

*25.*6"
25.0
25.0

25.0

100.0

100.0

100.0

100.0

10.3
&.1
10.3
15.4
17.9
12.8
20.5
2.6
5.1

100.0

74

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

5 3 .—D IST R IBU T IO N OF M AN U FAC TU R ER S AN D E M P LO Y E E S IN TH E G R A N ITECUTTING IN D U S T R Y OF B A R R E , V T ., AUGU ST, 1919, B Y Y E A R S OF EM PLO YM EN T
IN PR ESENT OCCUPATION AND NU M BER OF P R E V IO U S OCCUPATIONS—Continued.

T a b le

D R AFTSM EN.
Number of previous occupations.
Present employment.

Total.
None.

One.

Two.

8
7
3
2

3

2
3

15 to 19 years...........................................................
20 to 24 years...........................................................
25 to 29 years...........................................................
30 to 34 years...........................................................
35 to 39 years...........................................................
40 to 44 years...........................................................
45 to 49 years...........................................................
50 to 54 years...........................................................
55 to 59 years................. .......................................
Total..............................................................
Per cent of grand total........................................
Average period of present employment (years).

Five.

Six.

Number.

PERIOD.

0 to 4 years.............................................................
5 to 9 years.............................................................

Three. Four.

1

5
2

18
12
4
4

2

1

1
1

1

!
21 1
5
52.5
12.5
7.9
10.1

i

7

7

17.5
2.4

17. 5
2.4

28.6
42.8

71.4
28.6

40
...........
........... !............
i............
........... i............

100.0
7.4

Per cent.

PERIOD.

38.1
0 to 4 years............................................................
33.3
5 to 9 years............................................................
10 to 14 years........................................................... 14.3
9.5
15 to 19 years...........................................................
20 to 24 years...........................................................
4.8
25 to 29 years...........................................................
30 to 34 years...........................................................
35 to 39 years...........................................................
40 to 44 years...........................................................
45 to 49 years...........................................................
50 to 54 years.........................................................
55 to 59 years...........................................................
Total................................................................. 100.0

60.0

45.0
30.0
10.0
10.0

20. 0
28.6

2.5
2.5

20.0

100.0

100.0

100.0

100.0

ENGINEERS, FIREMEN, ELECTR ICIANS, AND M ACH INISTS.
Number.

PERIOD.

0 to 4 years.............................................................
5 to 9 years
...................
.
................
10 to
..........................................................
14 years
15 to 19 years...........................................................
20 to 24 years...........................................................
25 to 29 years...........................................................
30 to 34 years...........................................................
35 to 39 years...........................................................
40 to 44 years...........................................................
45 to 49 years...........................................................
50 to 54 years...........................................................
55 to 59 years...........................................................

3
1
1
2

1
2
1

1
3

1
1

1
1

1

1

1
1

5
4
5
2
5
1
1

Total.................................................................

6

4

4

4

2

2

1

23

Per cent of grand total.........................................
Average period of present employment (years).

26.1
27.7

17.4
6.5

17.4
10.2

17.4
10.5

8.7

8.7

4.3

100.0
14.5

0 to 4 years.............................................................
5 to 9 years............................................................
10 to 14 years........................................................... 16. 7
16. 7
15 to 19 years........................................ *................
20 to 24 years........................................................... 33.2
25 to 29 years...........................................................
30 to 34 years.........................................................
16.7
35 to 39 years 1.........................................................
16.7
40 to 44 years...........................................................
45 to 49 years...........................................................
50 to 54 years...........................................................
55 to 59 years...........................................................
Total................................................................. 100.0

75.0

Per cent.

PERIOD.




50.0
50. 0
25.0

25.0
75.0

50.0
50.0

25. 0
25.0

50.0

100.0

21.7
17.4
21.7
8.7
21.7
4.4
4.4

100.0

100.0

100.0

100.0

100.0

100.0

100.0

75

TRADE LIFE AND OCCUPATIONAL CHANGES.

5 3 .— D IST R IBU T IO N OF M ANUFAC TU R ER S AN D EM PLO Y EE S IN TH E G R A N IT E CUTTING IN D U S T R Y OF B A R R E , V T ., AU G U ST , 1919, B Y Y E A R S OF EM PLO YM EN T
IN PR ESEN T OCCUPATION A
. N D N U M BER OF PR EVIO U S OCCUPATIONS—Continued.

T a b le

BED SETTERS.
Number of previous occupations.
Present employment.

TotaL
None.

One.

Two. Three. Four.

Five.

Six

Number.
Oto 4 years—
5 to 9 years___
10 to 14 years..
15 to 19 years..
20 to 24 years..
25 to 29 years..
30 to 34 years..
35 to 39 years..
40 to 44 years..
45 to 49 years..
50 to 54 years..
55 to 59 years..
Total........
Per cent of grand total.........................................
Average period of present employment (years).

4.2
12.5

14
29.2
4.8

50.0
50.0

64.3
7.1
14.4
7.1

9.0

16.7
3.3

4.0

100.0
6.4

100.0

58.3
14.6
14.6
6.2
2.1
4.2

100.0

100. (

Per cent.
Qto 4 years___
5 to 9 years___
10 to 14 years..
15 to 19 years..
20 to 24 years..
25 to 29 years..
30 to 34 years..
35to 39 years..
40 to 44 years..
45 to 49 years..
50 to 54 years..
55 to 59 years..
Total........

100.0

87.5

66.7

12." 5

33." 3

7.1

42.0
31.6
10.5
5.3
5.3
5.3

100.0

100.0

100.0

100.0

TOOL GRINDERS AND TOOL CARRIERS.

0 to 4 years___
5 to 9 years___
10 to 14 years..
15to 19 years..
20 to 24 years..
25 to 29 years..
30to 34 years..
35to 39 years..
40 to 44 years..
45to 49 years..
50 to 54 years..
55 to 59 years..
Total........
Per cent of grand total...................................
Averageperiod of present employment (years)

60.8
1.9

17
21.5
1.6

79
11.4

2.5

1.3

100.0

2.3
Per cent.

0 to 4 years___
5 to 9 years___
10 to 14 years..
15 to 19 years..
20 to 24 years..
25 to 29 years..
30 to 34 years..
35 to 39 years..
40 to 44 years..
45 to 49 years..
50 to 54 years..
55 to 59 years..
Total........

61928°— 22— Bull. 293-------6




95.8
4.2

88.2
11.8

77.8

50.0
50.0

50.0
50.0

22." 2

*

100.0

100.0

100.0

100.0

100.0

100.0

7.6
2.5
1.3

100.0

DUST' PH TH ISIS IN T H E GRANITE-STONE INDUSTRY.

76

D IST R IB U T IO N OF M AN U FAC TU R ER S AND E M P LO YE ES IN TH E G R A N IT E CUTTING IN D U S T R Y OF B A R R E , V T ., AU G U ST, 1919, B Y Y E A R S OF E M PLO YM E N T
TN PR ESEN T OCCUPATION AND N U M BER O F PR EVIO U S OCCUPATIONS— Concluded.

TABLE $ 3 . —

LUM PERS, B O X E R S, AND D E R R IC K MEN.

Number of previous occupations.
Present employment.

Total.
None.

One.

Two. Three. Four.

Five.

Six.

Number.

84
39
34

Oto 4 years—
5 to 9 years—
10 to 14 years..
IS to 19 years..
20 to 24 years..
25 to 29 years..
30 to 34 years..
35 to 39 years..
40 to 44 years..
45 to 49 years..
50 to 54 years..
55 to 59 years..
Total.
Per cent of grand total.........................................
Average period of present employment (years)

19

16
10
1
1
1
1

11

«4

5.4
16.4

31.5
8.1

78

29

15

203

14.3
8.1

7.4
8.3

100.0

9.1

Per cent.
Oto 4 years....
5 to 9 years—
10 to 14 years..
15 to 19 years..
20 to 24 years..
25 to 29 years..
30 to 34 years..
35 to 39 years..
40 to 44 years..
45 to 49 years..
50 to 54 years..
55 to 59 years..

27.2
18.2
18.2
fi.l

Total.

100.0

9.1

37,5
34.4
7.8
7-8
9.4
3.1

37.2
16.7
24.3
3.8
7.7
7.7
1.3
1.3

51.7
6.9
20.7
10.3
6.9
3.5

60.0
13.4
13.3
13.3

100.0

41.4
19.2
16.7
7.9
7.9
4.9
.5
.5
.5
.5

100.0

100.0

'io.'o'

9.1
9.1

100.0

This table, for the first time, as far as is known, in occupationaldisease investigation, presents in a convenient form the essential facts,
which unquestionably have a direct bearing upon the observed mor­
tality rate from a certain specified cause of death. Limiting the
consideration for the time being to granite cutters only, it is shown
that of 1,137 men thus employed, 304, or 26.7 per cent, had followed
no previous occupation; 638, or 56.1 per cent, had followed one pre­
vious employment; 140, or 12.3 per cent, had followed two employ­
ments; 45, or 4 per cent, had followed three or more employments.
For all occupations the average length of employment in granite cut­
ting had been 17.7 years, but of those who had followed no previous
employment it was 21.6 years; of those who had had one previous
occupation, 16.4 years; of those who had two previous occupations,
16.7 years; and of those who had three or more previous occupations,
13.4 years.
That these figures are trustworthy is clearly indicated by the corre­
sponding figures for granite polishers, which give an average previous
trade life of 17.3 years, but for those who had followed no other
occupation 21.6 years. Important variations are disclosed by other




77

TRADE LIFE AND OCCUPATIONAL CHANGES.

occupations, which, however, do not seem to require extended dis­
cussion.
The facts are conveniently summarized in Table 54, which con­
tains the requisite data as well as the proportionate distribution for
1,872 persons employed in the granite industry at Barre, Yt. For
all such employees the average attained age was 37.2 years, or for
granite cutters 37.4 years, for granite polishers and sawyers 40.4
years, and for manufacturers and foremen 41.8 years. Certain occu­
pations are subject to selection, so that the age factor is of much
importance, but in the case of granite cutters, polishers, and sawyers
it may safely be assumed that once selected as a vocation the em­
ployment is generally followed throughout adult life. In all occupa­
tions employment changes at ages over 45 are few and far between.
Occupational elimination in advanced adult life is therefore more
probably the result of an excessive death rate than because of a
choice of other employments for reasons of better earning power or
better conditions of work.
5 4 .—DISTRIBU TION OF M ANUFACTURERS AND EM PLO YEES IN TH E GRAN ITECUTTING IN D U ST R Y OF B A R R E , V T ., AUGUST, 1919, B Y OCCUPATION AND YE A R S
OF EM PLO YM ENT IN PR ESENT OCCUPATION.

T a b le

Employment in
present occupation.

Engi­
neers,
Tool •
Manu­ Lump­
Granite fire­
ers,
grind­
polish­ men, factur­
Tool
boxers, Drafts­ Bed ers and
ers
Granite ers and electri­
Total.
sharp­ cutters.
tool
and
men. setters.
and
cians,
saw­
eners.
car­
fore­ derrickand
yers.
men.
men.
riers.
machin­
ists.
•

Number.

PERIOD.

0 to 4 years..............
5 to 9 years...............
10 to 14 years............
15 to 19 years.............
20 to 24 years.. .
25t o 29 years...........
30 to 34 years___
35 to 39 years*.,.
40 to 44 years.........
45 to 49 years___ . . . .
50 to 54 years.. . .
55 to 59 years..
Total................
Average period of
present employ­
ment (years)..........
Average age...............

4
2
4
a
7
5

92
169
194
205
179
132
•92
44
17
8
4
1

40
15
17
14
17
21
21
5
3

5
4
5
2
5

39

1,137

153

21.0
41.8

17.7
37.4

16.1
40.4

8

1
2

18
12
4
4

1
1

84
39
34
16
16
10
1
1
1
1

23

150

203

14.5
41.7

13.4
41.8

9.1
35.9

1
1

29
33
29
18
16
16
7

28
7
7
3
1
2

70
6
2
1

370
287
296
269
241
187
131
52
24
10
4
1

40

48

79

1,872

7.4
28.5

6.4
34.4

2.3
23.3

15.2
37.2

45.0
30.0
10.0
10.0

58.3
14.6
14.6
6. 2
2.1
4.2

88.6
7.e
2.5
1.3

.7
.7

41.4
19.2
16.7
7.9
7.9
4.9
.5
.5
.5
.5

19.7
15.3
15. 8
14. 4
12.9
10. 0
7. 0
2.8
1.3
.5
.2
.1

100.0

100.0

100.0

100.0

100.0

100.0

1
1

Per cent.
PERIOD.

0to 4 years.........
5 to 9 years...............
10 to 14 years.............
15 to 19 years.............
20 to 24 years___
25 to 29 years.........
30 to 34 years.........
35 to 39 years.............
40 to 44 years.............
45 to 49 years.............
50 to 54 years.............
55 to 59 years.........

10.3
5.1
10.3
15.4
17.9
12. 8
20. 5
2.6
5.1

Total...................

100.0




8.1
14.9
17.0
18.0
15.7
11.6
8.1
3.9
1. 5
.7

23.0
9.4
10.8
9.4
11. 5
15.1
15.1
3.6
2.2

21.7
17.4
21.7
8.7
21.7

100.0

100.0

4.4
4.4

19. 3
21.9
19.3
12.0
10. 7
10. 7
4.7

2. 5
2.5

.4

.1
100.0

78

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.
COMPARATIVE MORTALITY OF LIMESTONE WORKERS.

To emphasize this point to greater practical advantage, attention is
directed to Table 55, which gives a comparison of the ages of living
granite and limestone workers as determined by means of a special
personal inquiry, and at the same time the distribution of deaths, as
based on trade-union data, especially for granite cutters, limestone
and sandstone cutters, and glass-bottle blowers. In the case of
living granite cutters the proportion 50 years of age and over was
11.69 per cent as against 19.18 per cent for sandstone and limestone
cutters, the latter subject unquestionably as a group to a much lesser
occupational-disease liability than the former. Conversely, the
deaths at early years of life form 7.64 per cent in the experience of
granite cutters as against 4.05 per cent in the experience of sandstone
and limestone cutters. The glass-bottle blowers are hardly com­
parable with the other two groups in that among them proportion­
ately a much larger number of young persons are employed, which
accounts for the fact that of the deaths of these workers 15.74 per
cent occurred in ages under 30.
T a b l e 5 5 . — PR OPORTIONATE

AGE D ISTRIBUTION OF G R ANITE CUTTERS AT B A R R E ,
V T ., AND OF DEATHS FROM A L L CAUSES AMONG T H E GRAN ITE CUTTERS OF TH E
UNITED STATES AND CAN ADA, COMPARED W IT H T H A T OF SANDSTONE AND LIME­
STONE CUTTERS AND GLASS-BOTTLE BL O W E R S.

Granite cutters.

Age group.

Limestone
in
cutters 1
Deaths in
Employed, Deaths
United.
employed
United
at Barre,
V t., Aug­ States and at Bedford, States and
Canada,
Ind.,
Sep­
Canada,
ust, 1919.
tember,
1906-1919,
1888-1920.
1920.
Per cent.

10 to 14 years.....................................................
15 to 19 years.....................................................
20 to 24 years.....................................................
25 to 29 years.....................................................
30 to 34 years.....................................................
35 to 39 years......... * .........................................
40 to 44 years.....................................................
45 to 49 years.....................................................
50 to 54 years.....................................................
55 to 59 years................................... ..................
60 to 64 years.....................................................
65 to 69 years.....................................................
70 to 74 years.....................................................
75 to 79 years..............................................
80 to 84 years..................................................
85 to 89 years.....................................................
90 to 94 years.....................................................

Sandstone and lime­
stone cutters.

2.46
8.36
12.14
16.89
19.70
16.18
12.58
7.56
2.73
.88
.26
.26

P er cent.
2.28
5.36
8.45
11.38
13.03
13.37
14.61
10. 54
9.30
6.56
3.16
1.21
.45
.26
.04

Per cent.
0.26
4.35
9.97
13. 81
14. 58
15.09
13. 81
8.95
8.95
6.39
2.81
.77
.26

P er cent.
1.02
3.03
7.22
10. 88
15.02
14.06
12. 81
13 38
9.03
6.86
3.37
1.32
1.31
.51
.18

Glass-bottle
blowers—
deaths in
United
States and
Canada,
1892-1919.

P er cent.
0.04
3.85
11.85
15.50
14.17
11.27
10.07
7.75
6.66
5.54
5.76
3.61
2.54
.96
.43

Total............................................................

100.00

100.00

100.00

100.00

100.00

Under 30 years..................................................
30 to 49 years.....................................................
50 years and over..............................................

22.96
65. 35
11.69

7.64
46.23
46.13

28.39
52. 43
19.18

4.05
47.18
48. 77

15.74
51.01
33.25

Total ............................................................

100.00

100.00

100.00

100.00

100.00

1Includes planer men.

After all the most significant fact is the length of trade expo­
sure to dust-producing conditions and as shown by Table 56 gran­
ite workers throughout the entire comparative experience show
a larger proportionate distribution with the longer periods of dust
exposure. This table should be considered in conjunction with




79

TRADE LIFE AND OCCUPATIONAL CHANGES.

Table 28, which emphasizes the fact that most of the deaths from
pulmonary tuberculosis occurred among granite workers who had
been from 19 to 24 years exposed to the continuous and considerable
inhalation of granite dust. It is brought out by Table 56 that some
of the granite workers had suffered over 50 years of dust exposure
and yet were still alive and able to follow their occupation. Lime­
stone workers apparently represent a more recent trade develop­
ment, for comparing this group with granite workers it is shown that
in all the longer periods of dust exposure the proportion is considerably
higher among the latter than among the former, as, for illustration, at
20 to 24 years of exposure the percentage for granite cutters is 15.74,
as against only 7.16 for limestone workers, and at 25 to 29 years the
comparative proportion was 11.61 per cent for granite cutters, as
against 4.09 per cent for limestone workers.
5 6 .—PRO PORTIO NATE DISTR IBUTION OF LIVIN G GRANITE CUTTERS A T
BAR R E , V T ., B Y AGE AND Y E A R S OF E X P O SU R E TO GRANITE DUST, COMPARED
W IT H T H A T OF LIM ESTONE CUTTERS AND PLAN E R MEN IN LA W R EN C E CO U N TY,
IN D ., 1919-1920.

T a b le

[Heavy black squares show where the proportionate distribution of granite cutters equals or exceeds that
of limestone cutters. Figures in first line opposite age group are for granite cutters; in second line, for
limestone cutters and planer men.]
•Years of exposure to granite or limestone dust.
Age group.

Total
20 to 25 to 30 to 35 to 40 to 45 to 50 to 55 to
0 to 4 5 to 9 1014to 1519to
24
34
39
44
29
49
54
59
P .c t. P .c t. P .c t. P e t. P .c t. P .c t. P .ct. P .c t. P .ct. P .c t. P .c t. P .c t .

10 to 14 years

{o. 25

0.25

12. 46
15 to 19 years............. \4. 35

2. 46
4.35
8.36
9. 97

/4. 22
20 to 24 years............. \6.39

4.05
3.32

0.09
.26

/0. 53
25 to 29 years............. \2. 57

6. 33
5. 62

4.40
5. 36

0.88
.26

/0. 53
30 to 34 years............. \2. 05

1.76
4.09

6. 24
5. 89

7. 21
2. 30

1.06
.26

0.18

/o. 09
35 to 39 years............. \2.
05

1.31
2. 81

4.13
4. 85

5.37
3. 07

7.12
2. 05

1.41
.26

0.18

40 to 44 years............. /0. 26
\1.02

0. 79
1.29

1.41
5.13

2. 81
3.31

5.10
1.53

4. 40
1.01

1.32
.26

0. 09

f
45 to 49 years............. \0. 51

0. 44
.77

0.53
2.81

1.23
2. 05

1.76
1.28

3. 60
1.02

3. 52
.51

1.32
.26

0. 09

50 to 54 years............. {i.’02’

0. 09
.51

0. 26
1.53

0. 44
2. 05

0. 44
1.28

1.67
.77

2. 55
1.28

1.58
.25

0.44
.26

0.09

7. 56
8. 95

0.09
.77

0. 09
0.26 \0.
51
1.53

0. 26
.51

0. 35
.77

0. 34
1.02

0. 79
.51

0. 71
.51

0.18

2. 81
6. 39

0.18
0.77

0. 09
.26

0. 26
.51

0. 26
.26

0. 09

0.25

0. 09

0. 09

0. 08

0.18

0. 26
.26

0. 70
.26

0.36

0. 09 100.00
100.00

55 to 59 years.............
60 to 64 years

f
f
\0. 25

65 to 69 years............. { ........
1........ 0. 26
70 to 74 years............. { ........

12.14
13.81

0.51
0. 26

19. 61
15.09
16.18
13. 55
12. 49
9. 21

0. 25
0. 26

8.09 14. 86 17.06 18.03 15. 74 11.61
Total..................... 20. 97 19.69 26. 86 15.34 7.16 4.09




16.98
14.59

8.09
3.07

3. 87
1.28

1.50
1.28

0.88
2. 81
0. 09

0. 27
.77

80

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

It is not an easy matter to disentangle evidence more or less con­
flicting and contradictory. It might easily be assumed that because
granite workers show on an average a longer trade exposure than
limestone workers they are less liable to an excessive death rate from
lung disease at older ages, but, as clearly brought out by the mor­
tality analysis, the very opposite is the case. It will remain for those
who are qualified to do so to pass upon the question whether the
processes of lung fibrosis are not in their initial stages the cause of a
deferred mortality, while at the same time the certainty of ultimate
death from this disease is a foregone conclusion. If it were possible
to work out tables of mortality by duration of trade life in particular
occupations, much might be learned as to the direct consequences of
continuous dust inhalation. The nearest approach to this is Table 57,
in which granite and limestone cutters are compared with gold miners
in the Transvaal as to the years of employment at the occupation
now followed. The latter occupation is unquestionably, or was before
preventive measures were adopted, the most life-destructive em­
ployment known. Nowhere has the question of miner’s phthisis,
which is essentially a process of lung fibrosis, attracted more atten­
tion than in South Africa. But the table shows that continued em­
ployment for a considerable length of time is very rare especially as
compared with granite cutting, which, as. said before, is one of the
oldest of trades and includes a large proportion of men who have
been employed at stonework in some .capacity or other for more than
a generation. The suggestion may be placed on record that a thorough
examination of the survivors of long-continued trade exposure
would make a most useful practical contribution to the dust pathology of the granite industry. It is certainly as important to know
why men survive or do not succumb to health-injurious conditions
as why they fall victims to factors injurious to life and health more
or less accurately understood.
T able 5 7 .—PR OPORTIONATE D ISTR IBUTION OF TH E GR AN ITE CUTTERS OF BAR R E .
V T., BY Y EAR S OF E M PLO YM EN T IN PR ESENT OCCUPATION, COMPARED W IT H T H A T
OF T H E LIM ESTONE CUTTERS OF BED F O R D , IN D ., AN D TH E T R A N S V A A L GOLD
MINERS OF TH E UNION OF SOUTH AFRICA.

Employment in present occupation.

Limestone
Granite cutters
Transvaal
1of Bed­
of Barre, V t., ;cutters
gold miners,
ford, Ind.,
1918-19.2
Aug., 1919. : Sept.,
1920.

1 to 4 years........................................................... .....................
5 to 9 years.................................................................................
10 to 14 years.............................................................................
15 to 19 years.............................................................................
20 to 24 years.............................................................................
25 to 29 years............................................................................
30 to 34 years..............................................................................
35 to 39 years..............................................................................
40 to 44 years........... .................................................................
45 to 49 years............................................................................
50 to 54 years.............................................................................
56 to 59 years.............................................................................

Per cent.
8.09
14.86
17.06
18.03
15.74
11.61
8.09
3.87
1.50
.70
.36
.09

Per cent.
20.97
19.69
26.86
15.34
7.16
4.09
3.07
1.28
1.28
.26

Per cent.
50.18
40.04
8.49
1.17
.10
.02

Total........................ ................................................... 1 ___

100.00

100.00

100.00

1 Inclusive of limestone cutters, planer men, and milling-machine operators.
2 Annual Reports of the Miners’ Phthisis Board and Miners' Phthisis Medical Bureau, July 31,1919.




TRADE LIFE AND OCCUPATIONAL CHANGES.

81

The details of this analysis for the three groups of employments by
single years of trade life are given in Table 58. According to this
table recent employments among granite cutters in the State of Ver­
mont represented only 3.77 per cent for men having been employed
one year compared with 10.48 per cent for limestone workers and
10.12 per cent for the Transvaal gold miners. It is suggestive that
among the granite cutters the oldest employee now living should have
been 56 years at work.
5 8 .—PROPORTIONATE D ISTR IBUTION OF GR ANITE CUTTERS OF B A R R E , V T .,
B Y Y E A R S OF EM PLOYM ENT IN PR ESENT OCCUPATION, COMPARED W IT H T H A T
OF TH E LIMESTONE CUTTERS OF BED FO R D , IN D ., AN D TH E T R A N S V A A L GOLD
MINERS OF TH E UNION OF SOUTH AFRICA.

T a b le

Employment in present occupation.

1 year...........................................................................................
2 years . .
. .
..................................................
3 years.........................................................................................
4 years.........................................................................................
5 years.........................................................................................
6 years.........................................................................................
7 years.........................................................................................
8 years.........................................................................................
10 years.......................................................................................
11 years.......................................................................................
12 vears.......................................................................................
13 years.......................................................................................
14 years........................................................................................
15 years.......................................................................................
16 years.......................................................................................
17 years................................................................... ...................
18 years.......................................................................................
19 years.......................................................................................
20 years.......................................................................................
21 j^ears.......................................................................................
22 vears.......................................................................................
23 vears.......................................................................................
24 years.......................................................................................
25 years.......................................................................................
26 years........................................................................................
27 years........................................................................................
28 years........................................................................................
29 years........................................................................................
30 years.........................
.
.
...............................
31 years.......................................................................................
32 years........................................................................................
33 vears........................................................................................
34 years.......................................................................................
35 years.......................................................................................
36 years.............
.
...............................
37 years....... ................................................................................
38 y«ars..... .................................................................................
.....................................................
39 years.........................
40 years.......................................................................................
il vears.........
..
..................................................
42 years.......................................................................................
.
. . .
...............................
43 vears___
44years.... . ...........................................................................
45 years.......................................................................................
46 years___
..
..................................................
47 years..................................................................: ....................
48 vears.......................................................................................
49 vears.......................................................................................
50 vears___
. . .
..............................................
51 vears.......................................................................................
52 years.......................
..............................................
53 years................ ......................................................................
54 years.......................
.....................................................
55 years.......................................................................................
56 years.............. .
.
.....................................................
Total....................................................................................

cut­
Granite cutters Limestone
ters 1 of Bed­
of Barre, V t., ford,
Ind., Sep­
August, 1919.
tember, 1920.
Per cent.
3.77
1.68
1.32
1.32
3.42
2.84
3.25
2.63
2.72
4.82
1.32
«. 12
2.98
4. 82
4. 30
2. 81
3.86
3.73
3.33
5.96
1.93
2. 72
2. 85
2. 28
2. 89
1.58
3.07
2.14
1.93
4.12
.70
1.58
.64
1.05
1. 40
.72
.44
.96
.35
.18

Per cent.
10.48
3. 08
1. 53
5. 88
2.55
3. 84
3. 84
4.86
4.60
8.17
3.58
5.65
2.30
7.16
5. 63
4.60
1.79
3. 06
.26
3.07
.77
1.28
1.27
.77
1.02
.51
1. 79
.26
.51
1 79

Transvaal
gold miners,8
1918-19.

P er cent.
10.12
11.73
15.14
13.19
10.94
9.17
8.46
6.94
4.53
3.01
2.26
1.49
1.10
.63
.48
.31
.23
.10
.05
.05
.02
.01
.01
.01
.01
.01

.26
.51
.51
.26
.50
.26
.26
1.02
.26

.36
.70
.26
.44
.09
.09
.26
.08
.18
.09
.09
.09
100. 00

100. 00

100. 00

1Inclusive of limestone cutters, planer men, and milling-machine operators.
2Annual Reports of the Miners' Phthisis Board and Miners’ Phthisis Medical Bureau, July 31,1919.




82

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

SUPPLEMENTARY CONSIDERATIONS.
AVERAGE AGE AT DEATH.

The foregoing discussion has been made to include certain sup­
plementary considerations which will be found of both interest and
value in the interpretation of the major portion of the information
considered. Table 59 gives the details of the mortality from all
causes and the aggregate years of life lived during the period
1906-1918, with the average age at death.
T a b le

5 9 .—A V E R A G E AGE AT D E A T H OF TH E G R AN IT E CU TTERS OF THE U N ITED
STATES AN D CAN A D A , 1906 TO 1918, B Y Y E A R S .
[Data from experience of the Granite Cutters’ International Association of America.]

Year or period.

1906.........................................
1907 .......................................
1908.........................................
1909.........................................
1910.........................................
1911.........................................
1912.........................................
1913.........................................
1914.........................................

Deaths
from all Years
causes. of life.

144
138
149
111
179
178
165
206
217

6,326
6,626
6,805
5,279
8,574
8,953
8,234
10,357
JO, 981

Aver­
age
age at
death.
43.9
48. 0
45. 7
47.6
47.9
50.3
49. 9
50. 3
50.6

Year or period.

Deaths
from all Y ears
causes. of life.

Aver­
age
age at
death.

1915...................................
1916.............
1917.......................................
19181..............
1918 2...................................

202
206
213
167
397

10,418
10,516
10,655
8,369
16,809

51.6
51.0
50.0
50.1
42.3

1906-1909..............................
1910-1914..............................
1915-19181...........................

542
945
788

25,036
47,099
39,958

46.2
49.8
50.7

1 Exclusive of last three months of 1918.

3 Entire year of 1918.

There is probably no more misleading figure in mortality statistics
than the average age at death unless used with extreme caution as
an indication of a possible improvement in longevity.® The average
age at death is of course profoundly influenced by the average age
oi the living, which varies in practically every trade, industry, and
locality. In the experience of the Granite Cutters’ International
Association of America, embracing men employed throughout the
United States and Canada, the average age at death has slowly
increased from 46.2 years during 1906-1909 to 50.7 years during
1915-1918. The indicated increase of 4.5 years reflects, broadly
speaking, the health progress of the country at large, obscuring the
detrimental tendencies elsewhere shown to have resulted from a
larger exposure to health-injurious dust. Taking the period under
observation by single years, it appears that during 1906-1918,
excluding the last three months of that year, the average age at
death was increased 6.2 years. According to Table 60, in comparison
with sandstone and limestone cutters and glass-bottle blowers, this
increase is in fair conformity to the general health progress of the
country.
a See observation on the “ average age ” question on p. 18.




83

SUPPLEMENTARY CONSIDERATIONS.

6 0 __ A V E R A G E AGE A T D E A T H OF GR AN ITE CU TTERS, COM PARED W IT H
T H A T OF SAND STONE AN D LIM ESTONE CUTTERS A N D G LASS-BO TTLE B L O W E R S ,
OF U N IT ED STATES A N D CAN AD A, 1889 TO 1920, B Y Y E A R S .

T a b le

Year or period.

Sand­
stone
GlassGranite and
bottle
cutters. lime­ blowers.
stone
cutters.

1889.......................................
1890.......................................
1891.......................................
1892.......................................
1893.......................................
1S94.......................................
1895......................................
1896.......................................
1897.......................................
1898.......................................
1899.......................................
1900.......................................
1901.......................................
1902.......................................
1903.....................................
1904.......................................
1905.......................................
1906.......................................
1907.......................................
1908.......................................

53. 0
46. 4
44.1
41. 4
42.1
43. 8
40.1
42. 7
48.5
43.1
48.2
47.8
45. 2
49. 2
46. 4
50.1
51.3
49. 6
51.6
47.7

43.9
48.0
45.7

37. 0
40.4
39. 4
37. 4
43. 0
39. 8
41.9
40. 8
40.1
42. 2
40. 3
42.7
39. 6
41. 5
43. 9
42.5
43.6

Year or period.

1909.......................................
1910.......................................
1911.......................................
1912.......................................
1913.......................................
1914.......................................
1915.......................................
1916.......................................
1917.......................................
19181....................................
1918 2....................................
1919.......................................
1920 3....................................
1889-1894.............................
1895-1899..............................
1900-1904.............................
1905-1909..............................
1910-1914..............................
1915-1918 1...........................

Sand­
stone GlassGranite and
cutters. lime­ bottle
stone blowers.
cutters.
47.6
47.9
50.3
49.9
50.3
50.6
51.6
51.0
50.0
50.1
42.3
49.1

5 46.2
49. 8
50.7

50.0
49. 9
52.6
51. 4
51. 8
52. 5
53.6
52.2
55. 8
55.9
53.1
53.1
56.0

44.7
45.7
46.7
48.1
44.4
47.5
48.5
50.6
49.7
46.9
42.5
50.5

43.0
44.2
47.8
50.0
51.5
54.3

< 39.0
40.9
40.9
43.2
46.5
48.9

1 Exclusive of last three months of 1918.
s Entire year of 1918.
* First nine months of 1920.
* 1892-1894.
61906-1909.

Comparing the period 1915-1918 with 1905-1909, against an in­
crease of 4.5 years in the average age at death of granite cutters the
increase for sand and limestone cutters has been 4.3 years, but for
glass-bottle blowers the increase was 5.7 years. In the latter case
there are reasons for believing that health improvements in the trade
itself account, in part at least, for the longer average duration of life
or the higher average age at death.
Since the present investigation is chiefly concerned with pulmonary
tuberculosis, Table 61 has been included, showing the proportionate
mortality from tuberculosis in the experience of the Granite Cutters*
International Association of America for the period 1906 to 1918 and
of the industrial experience of the Prudential Insurance Co. of America
for the period 1914 to 1917, including under the term “ stoneworkers,” however, marbleworkers and others engaged in stoneworking
processes. This table emphasizes the fallacy of using insurance
experience data for comparative purposes without a due considera­
tion of all the facts involved, particularly the element of selection,
which though not very stringent in the case of industrial insurance
is nevertheless reflected in the more favorable proportionate mortality
particularly at the older age. Comparing all ages, the percentage that
deaths from pulmonary tuberculosis were of the mortality from all
causes was 57.3 per cent for the granite-cutters union as against 33.8
per cent for marble and stone workers in the Prudential experience.
There is, however, no question but that marble workers particularly
are subject to a more favorable experience than granite cutters. The
same conclusion applies to limestone workers and possibly to other




84

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.

important branches of the stone industry. Particularly suggestive
is the high proportionate mortality figure from tuberculosis* among
granite cutters at ages 45 and over.
6 1 .—PR O PO R TIO NA TE M O R T A L IT Y FROM PU L M O N AR Y TUBERCULOSIS AMONG
T H E GR ANITE CUTTERS OF VER M O N T, 1906 TO 1918,1 COM PARED W IT H T H A T OF
M AR B L E A N D STONE W O R K E R S , 1914 TO 1917, B Y AG E G ROUP.

T a b le

[Data from experience of the Granite Cutters’ Internationa 1Association of America, and industrial ex­
perience of Prudential Insurance Co.]

and stone workers
Granite cutters (1906 to 1918).1 Insured marble
(1914 to 1917).2
Deaths from pul­
monary tuberculosis.

Age at death.
Deaths
from all
causes.

Number.

Per cent
of deaths
from all
causes.

Deaths from pul­
monary tuberculosis.
Deaths
from all
causes.
Number.

Per cent
of deaths
from all
causes.

15 to 24 years..............................................
25 to 34 years..............................................
35 to 44 years..............................................
45 to 54 years..............................................
55 to 64 years..............................................
65 years and over......................................

14
80
202
203
93
21

4
46
115
134
48
4

28.6
57.5
56.9
66.0
51.6
19.0

17
37
85
124
159
98

5
19
41
54
50
7

29.4
51.4
48.2
43.5
31.4
71.

Total..................... ..............................

613

351

57.3

520

176

33.8

1 Exclusive of last three months of 1918.
2 Inclusive of block makers, cleaners, cutters, drillers, foremen, grinders, inspectors, laborers, and monu­
ment makers.

It has not been feasible to calculate extended mortality tables
by single years of life, but as a contribution toward possible further
investigation in this direction Table 62 is included, giving by single
years all deaths in the experience of the Granite Cutters’ Inter­
national Association for the period 1906 to 1919, and including 2,723
deaths.® This table illustrates the need of a large and extended
exposure to permit of the calculation of normal frequency curves
without the use of mathematics. The table on the whole, however,
fairly indicates the normal age distribution among granite cutters
and the concentration of deaths at a relatively later period of adult
life than normally met with, but falling far short at the older ages,
particularly at ages 80 and over. This can only be explained by the
excess mortality from pulmonary tuberculosis, or more acurately
dust phthisis, at ages 40 and over.
a See, however, in this connection the discussion on pp. 35 and 36 and Table 19.




85

SUPPLEMENTARY CONSIDERATIONS.
T a b le

6 2 .—M O R T AL IT Y FROM A L L CAUSES AMONG THE GRANITE CUTTERS OF THE
UN ITED STATES AN D CANADA, 1966 TO 1919, B Y AGE.
[Data from experience of the Granite Cutters’ International Association of America.]

Deaths.

Deaths.

Age at death.

Age at death.
Number. Per cent.

20 years.
21 years
22 years
23 years
24 years
25 years.
26 years
27 years
28 years
29 years
30 years
31 years
32 years
33 years
34 years
35 years
36 years
37 years
38 years
39 years
40 years
41 years
42 years
43 years
44 years
45 years
46 years
47 years
48 years
49 years
50 years
51 years
52 years
53 years
54 years
55 years
56 years
57 years

0.15
.33
.51
.59
.70
.81
1.14
1.10
1.17
1.14
1.65
1. 51
1.95
1.65
1.69
2.24
2. 35
2.24
2. 42
2.13
3. 01
2.17
3. 08
2. 35
2. 42
2. 57
2. 72
2. 57
2. 83
2.68
3. 33
2. 72
3.27
2. 72
2.57

Number. Per cent.

2. 20

58 years...
59 years. . .
60 years...
61 years...
62 years...
63 years. . .
64 years. . .
65 years. . .
66 years. . .
67 years. . .
68 years. . .
69 years. . .
70 years...
71 years. . .
72 yeais...
73 years...
74 years. . .
75 years...
76 years. . .
77 years. . .
78 years...
79 years...
80 years. . .
81 years. . .
82 years. . .
83 years. . .
84 years -.85 years. . .
86 years...
87 years-.88 years. . .
89 years. . .
90 years - ..
91 years...
92 years. . .
93 years. . .

2. 28
2.02

Total.

1.95
2. 09
1.84
2.02
2.17
1.80
1.47
1.32
1.36
1.65
1.17
1.06
.92
.55
.70
.70
.29
.22
.33
.22
.26
.18
.15
.15
.11
.04
.22
.04

.04
2,723

100.00

MORTALITY OF GRANITE MANUFACTURERS,

In the foregoing discussion granite workers, represented chiefly by
granite cutters, have been considered separately from granite manu­
facturers. The latter represent, however, a group of granite workers
of exceptional interest in that, with few exceptions, granite manufac­
turers are men who formerly worked at trades as journeymen, chiefly
as granite cutters, and although relieved from much of the most
injurious dust exposure the nature of their work requires close super­
vision and frequent presence in the granite-cutting sheds. It has,
therefore, been considered advisable to include a table showing the
proportionate mortality from pulmonary tuberculosis among granite
manufacturers as well as among granite cutters in the State of Ver­
mont, in the State of Massachusetts, and in Rhode Island and Con­
necticut combined, and also in the States of Maine and New Hamp­
shire, considered as a group. According to Table 63 a large portion
of the deaths from piumonary tuberculosis in every group are con­
centrated in the age period 40 to 49, or from 63.2 per cent of the
mortality from all causes for granite manufacturers and 62.8 per cent
for granite cutters of Vermont to 58 per cent and 56.3 per cent for
the other two geographical groups. This result is rather unexpected,
as it has generally been assumed that granite manufacturers, because




86

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

of a lesser exposure, were more free from the occupational hazards of
the employment. The data suggest that in the light of the previous
discussion manufacturers suffer the consequences of early exposure,
terminating fatally on the average in a trade life of about 21 years.
Considering all ages, the results are somewhat favorable for granite
manufacturers, but the differences are not sufficiently striking to set
aside the conclusion that for practical purposes granite manufacturers
suffer proportionately about as much from tuberculosis as granite
cutters. For all ages combined, the percentage that deaths from
pulmonary tuberculosis were of the mortality from all causes is 49.1
m the case of granite manufacturers and 57.3 in the case of granite
cutters for the State of Vermont and 41.3 and 47.6, respectively, for
the other two geographical divisions considered. The foregoing dis­
cussion leaves no other conclusion than that the nature and the
degree of dust exposure primarily determine the worker’s liability
to dust phthisis, generally diagnosed as pulmonary tuberculosis.
0?ABLE 6 3 . — PR O PO R TIO N A TE

M O R T A L IT Y FROM PU L M O N A R Y TUBERCULOSIS AMONG
T H E GR AN ITE M AN U FAC TU R ER S OF W ASH IN G TO N AN D CALED O N IA COUNTIES,
V T ., COMPARED W IT H T H A T OF GR AN ITE CUTTERS IN T H E N E W EN G LAN D STATES,
B Y AGE GROUP.

Granite manufac­
turers.1

Granite cutters.2

Massachusetts,
Connecticut, and
Rhode Island.

Vermont.
Deaths from
pulmonary
tuberculosis.

Age at death.

Deaths
from
all
causes.

Deaths from
pulmonarv
tuberculosis.

Maine and New
Mampshire.

Deaths from
pulmonary
tuberculosis.

Deaths from
pulmonary
tuberculosis.

Deaths
Deaths
Deaths
from
from
from
Per
Per
Per
Per
cent of all
cent of all '
cent of all
cent of
causes.
causes.
causes.
deaths
deaths
deaths
deaths
No. from
No. from
No. from
No. from
all
all
all
all
causes.
causes.
causes.
causes.

20 to 29 years..................
30 to 39 years..................
40 to 49 years..................
50 to 59 years..................
60 to 69 years..................
70 to 79 years..................
80 years aud over..........

8
19
14
12
2

3
12
8
4

37.5
63.2
57.1
33.3

53
129
226
154
45
6

30
68
142
93
18

56.6
52.7
62.8
60.4
40.0

24
86
131
174
145
45
10

10
37
76
76
46
9

41.7
43.0
58.0
43. 7
31.7
20.0

12
31
71
97
61
18
2

5
19
40
43
28
4

41.7
61.3
56.3
44.3
45.9
22.2

Total.....................

55

27

49.1

613

351

57.3

615

254

41.3

292

139

47.6

11898-1918, exclusive of the last quarter of 1918.

2 1906-1918, exclusive of the last quarter of 1918.

DIFFERENCES IN STONE COMPOSITION.

A thorough scientific investigation would have to take into account
the true nature of the dust inhaled in particular shops and under
particular working conditions, since the composition of the stone
often varies widely. Especially is this so in the case of limestone
and sandstone cutting, where the range may be from constituents of
comparative harmlessness to those of most deadly seriousness. It
may be laid down as a general principle that the injuriousness of the
dust is proportionate to the silica content, and to emphasize the
wide range in conditions, particularly as regards limestone and




87

SUPPLEMENTARY CONSIDERATIONS.

marble workers, Table 64 is included as a preliminary contribution
toward a more extended study of the dust problem in granite
cutting, particularly that now in progress by the United States
Bureau of Mines.
This table shows that the proportion of silica in the dark Barre
granite is 69.89 per cent, in Lake Superior sandstone 87.02 per cent,
in Indiana limestone 1.00 per cent, while there is practically no
silica in the white marble of Rutland, Vt. Conversely, there is
practically no calcium carbonate in the Vermont granite or the
Lake Superior sandstone, although it forms 97.27 per cent of Indiana
limestone and 90.7 per cent of the white marble of Rutland, Vt.
Unless such differences in stone composition are taken into account
the conclusions affecting mortality and disease liability may be
widely at variance with the facts.
T a b le

6 4 .—

T YPICAL CHEMICAL A N ALYSIS OF G R A N IT E , LIM ESTONE, SANDSTONE,
AND M A R B L E .

Constituent.

Silica (S i02)...............................................................................
Alumina ( A I 2 O 3 ) ................................................................... ...............
Soda (N a*0)..............................................................................
Potash (K 2O )...........................................................................
Lime (CaO)...............................................................................
Calcium carbonate (CaC03) ...................................................
Iron oxide ( FeO).....................................................................
Iron sesquioxide (Fe203) ........................................................
Other elements.........................................................................
Total....................................................................................

Dark
Barre
granite.1

Per cent.
69.89
15.08
4.73
4.29
2.07
1.46
1.04
1.44
100.00

White
Indiana
Lake
oolitic
Superior marble * of
Rutland.
limestone.2 sandstone.8
V t.
Per cent.
1.00
.33

P er cent.
87.02
7.17
.22
1.43
.11

97.27

P er cent.
0.39

90.70
.14

.59
.81

3.91
.14

8.77

100.00

100.00

100.00

1 Dale, T. Nelson: The Granites of Vermont, United States Geological Survey Bui. 404, p. 51.
s Blatchley, Raymond S.: The Indiana Oolitic Limestone Industry in 1907, Thirty-second Annual
Report of the Department of Geology and Natural Resources, Indiana, 1907, p. 376.
8 Buckley, E . R .: The Building and Ornamental Stones of Wisconsin, Wisconsin Geological and Natural
History Survey Bui. No. 4, Economic Series No. 2, 1898; p. 175.
* Clarke, F. W .: Analyses of Rocks and Minerals, United States Geological Survey Bui. 591, p. 225.

REGULARITY OF EMPLOYMENT.

Finally, there are the factors of labor and shop conditions. It
does not fall within the province of the present discussion to enlarge
upon these aspects, which would require explanations in detail of
processes of manufacture, dust removing, apparatus, etc., each of
which represents a subject demanding special consideration. In the
course of the investigation, however, some very interesting material
was collected as regards vacation time and periods of involuntary
idleness, absence on account of sickness, etc., which it seems well
worth while making a matter of permanent record. According to
Table 65, of 1,869 granite workers (including all occupations) 1,449,
or 77.53 per cent, had no vacation during the year, while the remain­
der had vacation periods averaging 34 days. Of the 1,869 the num­
ber who experienced no periods of involuntary idleness was 1,834, or
98.13 per cent. The average length of the periods of idleness of the
remainder was 75.7 days.
Of exceptional interest are the data regarding absence on account
of sickness, which, however, include the influenza period of 1918 and
must therefore be accepted with due reserve. Out of 1,869 em-




88

dust

p h t h is is

in

the

g r a n it e -s t o n e

in d u s t r y .

pioyees 899, or 48.1 per cent, were absent more or less on account of
sickness, the average duration of such sickness being 26.5 days.
The distribution of sickness by length of time is of special interest, it
being shown that the major portion was of less than four weeks’
duration. There can be no question, however, that sickness, gen­
erally speaking and particularly of course from nontubercular respira­
tory affections, is more common among granite workers than among
men employed in other trades. It may be pointed out in this con­
nection that the death rate per 1,000 from all causes, which was 26.2
for granite cutters during 1918, excluding influenza, is increased to
46.7 when influenza is included. For sandstone and limestone cut­
ters the death rate per 1,000 from influenza was only increased from
19.8 to 25.8, and for glass-bottle blowers from 17.0 to 25.9. These
results strikingly confirm the earlier observations in these discussions
regarding the decidedly fatal aspect of influenza among the granite
cutters of the Barre district.
6 5 .—DISTRIBUTION OF G R ANITE W O R K E R S OF B A R R E , V T ., ACCORDING TO
VACATIO N TIME, IN V O L U N T A R Y IDLEN ESS. AN D ABSENCE FROM W O R K ON
ACCOUNT OF SICKNESS, AUG UST, 1918, TO AUG UST, 1919.

T a b le

Vacation.

Involuntary idle­
ness.

Absence on account
of sickness.1

Period of unemployment.
Number
of work­
ers.

Per cent
of
total.

Number
of work­
ers.

Per cent
of
total.

Number
of work­
ers.

N one....................................................................
1 to 6 days..........................................................
1 week.................................................................
2 weeks..............................................................
3 weeks...............................................................
4 weeks...............................................................
5 weeks...............................................................
6 weeks...............................................................
7 weeks...............................................................
2 months...........................................................
3 months.............................................................
4 m o n t h s .........................................................................
5 months.............................................................
6 months and over...........................................

1,449
18
93
113
32
63
6
11
2
26
38
7
5
6

77.53
.96
4.98
6.05
1. 71
3.37
.32
.59
.11
1.39
2.03
.37
.27
.32

1,834
1
1
6
1
7
1

98.13
.05
. 05
.32
.05
.38
.05

5
2
4
2
5

.27
. 11
.21
.11
.27

970
159
126
225
95
100
31
28
6
64
40
8
7
10

51.90
8.51
6. 74
12. 04
5.08
5. 35
1.66
1.50
.32
3.42
2.14

Total............................................................

1,869

100. 00

1,869

100.00

1,869

100.00

Average period (days).....................................

34,.0

75.7

Per cent
of
total.

.43-

.37
.54

26.5

i Inclusive of influenza of 1918,

Table 66 presents the comparative results for granite workejs
and limestone workers, based, for limestone workers, upon an
original investigation during the two years 1919 and 1920. In the
first place it is significant that while 77.53 per cent of the granite
cutters had no vacation, the proportion of limestone workers having
no vacation was 94.95 per cent. The comparison illustrates clearly the
superior economic condition of the granite cutters. For the granite
cutters who took a vacation the average length of such vacation
was 34 days as against only 29.6 days for limestone workers. Thus
not only was a larger proportion of granite cutters free from the
burden of work during a part of the year, but the period of freedom
was longer than in the case of limestone workers, although the latter
group experiences a decidedly lower mortality from pulmonary
tuberculosis.




89

COMPARATIVE OCCUPATIONAL MORTALITY DATA.

In the case of involuntary idleness a larger proportion of lime­
stone workers were absent from work, but the duration of such
absence was less. The period of involuntary idleness in the case
of granite cutters was 75.7 days, as against 56.9 days for limestone
workers. Absence on account of sickness did not affect 51.9 per
cent of the granite workers as against 72.02 per cent for limestone
workers. Of those who were absent on account of sickness the
duration was practically the same, being, respectively, 26.5 days for
granite cutters and 25.6 days for limestone workers. These data,
while not finally conclusive, are suggestive of the better economic
condition of granite cutters as compared with limestone workers,
but are decidedly less favorable regarding the loss of time on account
of sickness, attributable without question to inherent conditions of
the employment rather than to other predisposing causes.
T able 6 6 .—PROPORTIONATE D ISTR IBU TION OF GR AN ITE W O R K E R S OF B A R R E , V T .,
ACCORDING TO VACATION T IM E, IN V O L U N T A R Y ID LEN ESS, AN D ABSENCE FROM
W O R K ON ACCOUNT OF SICKNESS, AUGUST, 1918, TO AUGUST, 1919, COMPARED W IT H
T H A T OF LIMESTONE W O R K E R S OF LA W R E N C E CO U N TY, IN D ., 1919 TO 1920.

Involuntary idle­
ness.

Vacation.
Period.
Granite
workers.

None...................................................................
1 to 6 days..........................................................
1 week.................................................................
2 weeks...............................................................
3 weeks...............................................................
4 weeks...............................................................
5 weeks...............................................................
6 weeks...............................................................
7 weeks...............................................................
2 months............................................................
3 months............................................................
4 months............................................................
5 months............................................................
6 months and over...........................................

Lime­
stone
workers.

Per cent. Per cent.
77.53
94.95
.56
.96
.93
4.98
6.05
1.86
1. 71
.56
3.37
.32
.59
.11
.47
1.39
2.03
.47
.37
.10
.27
.32
.10

Absence on account
of sickness.

lim e ­
Lime­
Granite
Granite
stone
stone
workers.*
workers. workers.1
workers.
Per cent.
98.13
.05
.05
.32
.05
.38
.05

Per cent.
61.29
.37
1.31
3.45
3.17
7.37

.27
.11
.21
.11
.27

13.25
6.81
1.68
.37
.93

Per cent. Per cent.
72.02
51.90
8.51
6.34
6.74
4.48
12.04
6.44
5.08
2.98
5.35
2. 80
1. 66
1. 50
.32
3.42
3.08
.84
2.14
.43
.37
.37
.28
.54
.37

Total............................................................

1QQ.0Q

100.00

100.00

100.00

100.00

100.00

Average period.....................................days..

34.0

29.6

75.7

56.9

26.5

25.6

1 Inclusive of time lost through strikes.
2 Inclusive of influenza of 1918.

COMPARATIVE OCCUPATIONAL MORTALITY DATA*
MORTALITY OF LIMESTONE AND SANDSTONE CUTTERS AND GLASSBOTTLE BLOWERS.

The comparative mortality of granite workers and of men em­
ployed in similar dusty trades has not heretofore been made the sub­
ject of an extended and thoroughly qualified investigation. Even
the present inquiry does not justify entirely safe conclusions, but it
has seemed worth while to bring together the available data likely
to prove useful in connection with further investigations. The most
trustworthy data available for the purpose are the statistics of the
limestone cutters’ union arrived at by the same method as has been
followed in the case of granite cutters, the data being differentiated




90

BUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

as regards limestone and sandstone cutters on account of the wide
differences in occupational hazards. In addition there are available
the statistics of glass-bottle blowers, and all of the four groups of
data are compared with the mortality of the adult male population
of Massachusetts.a
Table 67 shows the mortality from all causes among granite cutters
of the United States and Canada, compared with sandstone cutters,
limestone cutters, glass-bottle blowers, and the adult male popula­
tion of New England. The data are strictly comparable since 1905
and indicate a marked increase in the death rate for granite cutters,
a stationary condition for sandstone cutters, a diminishing death rate
for limestone cutters, a slightly increased rate for glass-bottle blowers,
and a stationary condition for the adult male population of New
England. These rates have not been standardized on account of the
varying age constitution of the different occupational groups con­
sidered, but for practical purposes they would seem to be conclusive.
a The present investigation clearly emphasizes the fallacy of combining stone workers’ mortality data
by grouping occupations with a widely varying dust hazard. In the medico-actuarial mortality inves­
tigation dv the Association of Life Insurance Medical Directors and the Actuarial Society of America in
1912, for illustration, journeymen stonecutters are considered as a group, yielding a ratio of actual to ex­
pected mortality of 214 per cent. The resulting conclusion may safely be said to apply practically ex­
clusively to granite and sandstone cutters, while it fails to disclose the much more favorable position of
limestone workers. The medico-actuarial investigation, furthermore, fails on the ground of insufficient
data in that the total number of deaths considered was only 76. Objection may also be raised to the term
“ journeymen,” which is practically never used in actual experience, the men employed being designated
by the occupational terms used in the present investigation. It may be pointed out at the same time that
in dusty trades the health-injurious consequences rarely affect younger ages, and that therefore the inclu­
sion of apprentices in a combined experience is most likely to impair the resulting conclusions. The results
of the medico-actuarial investigation in detail are as follows:
Medico-actuarial experience.

Ratio of
actual
Expected deaths
to
deaths. expected
deaths.

Exposed
to risk.

Actual
deaths.

15 to 29 years............................................................................................
30 to 39 years............................................................................................
40 to 49 years............................................................................................
50 to 59 years............................................................................................
60 years and over....................................................................................

2,579
2,289
681
138
3

17
32
22
5

11.96
13.44
6.75
3.20
.10

All ages..........................................................................................

5,690

76

35,44

Age group.

Per cent.
142
238
326
156
214

According to this experience, out of 5,690 stone workers exposed to risk 4,868, or 85.6 per cent, were under
40 years of age. Since about 20 years is required to show the full effect of stone-dust exposure, the element
most liable to the after effects of such exposure was practically not represented in the medico-actuarial
experience. (See age distribution of stone workers by single years of life, pp. 35, 36.)




T able 6 7 .—M ORTALITY FROM ALL CAUSES AMONG GRANITE CUTTERS OF T H E U N ITED STATES AND CANADA COMPARED W IT H THAT OF
SANDSTONE AND LIMESTONE CUTTERS AND GLASS-BOTTLE BLO W ERS OF THE U N ITED STATES AN D CAN AD A AND THE AD U LT MALE
POPULATION OF N E W ENGLAN D, 1889 TO 1920.

Number

384
296
426
685
945
788

14.3
14.3
11.4
14.6

21.0
23.6

12, 850
11, 593
5,146

325
290
133

i Connecticut excepted.
s New Hampshire, Vermont, Massachusetts, and Rhode Island*




25.3
25.0
25.8

22,018
19,304
12, 690

79

110

77

452
359
215

23.2
18.6
25.5
17.4
18.3
18.2
25.1
16.5
16.5
16.2
17.6
16.0
17.6
16.6
19.9
20.4
15.2

20.5
18.6
16.9

Death
Number
Deaths. rate per
exposed.
1,000.

2,580
2, 536
2,676
2, 560
2,455
2,333
2,386
3,643
4,302
5,309
6,207
6,799
7,177
7,311
8,093
8,631
8,384
9,035
8,854
8,682
9,166
8,719
8,544
7,776
7,790
8,466
6,425
8,567
8,072
7,792
13,377
29,694
41, 454
43, 964
30, 457

3 Exclusive of last 3 months of 1918.
* Entire year ©f 1918.

23

22
29

20

34
26
28
35
42
6Q
66

72
99
95
96

112
116
92
125
118
113
114
116
122
114
94
109
222

8.7
10.8
7.8
13.8

11.1
11.7
9.6
10.0
11.3
10.6
10.6

13.8
13.0
11.9
13.0
13.8
10.2

14.1
13.6
12.3
13.1
13.6
15.7
14.6
11.1

17.0
25.9

11.0
74
143
339
511
586
439

9.5
10.7
11.4
12.3
13.3
14.4

6,927,129
6,963,541
7,539, 701
8,137,610
8,876,260
5,396,711

130, 889
123, 560
134,025
144,221
155, 905
95,602

6 First 9 months of 1920.
61915-1917*

18.9
17.7
17.8
17.7
17.6
6 17.7

DATA,

26,851
20,673
37,322
47,068
45,092
33,439

1895-1899..
1900-1904..
1905-1909..
1910-1914..
1915-19183.

4.221
4,245
4,315
4,434
4,803
4,618
3,944
3,766
3,581
3,395
3,069
3,681
3,524
2,416
3.221
2,108
2,506

Death
rate per
1 ,000.

MORTALITY

1897..
1898..
, 1899..
^ 1900..
1901..
1902..
1903..
1904..
1905..
1906..
1907..
1908..
1909..
1910..
1911..
1912..
1913..
1914..
1915..
1916..
1917..
19183.
19184.
1919..
1920 5.

Number
Deaths
exposed.

Male population of New Eng
land 1 (20 years of age and
over).
Death
Popula­
Deaths. rate per
tion.
1,000.
17, 530
217.7
989, 392
18,961
2 18.6
1,016,405
19.532
2 18.8
1,038,240
20.3
25,759
1,270, 871
19.5
25,197
1,294, 364
18.1
23,910
1,317, 857
18.1
24,228
1,341, 352
17.9
24.533
1,367,030
17.5
24,318
1,392,708
24,892
17.5
1,418,386
17.7
25,589
1,444,065
26,352
17.9
1,469,744
18.1
26,969
1,488, 842
17.2
25,869
1,507,940
17.8
27,186
1,527,038
17.9
27,649
1,546,137
18.2
28,497
1,565, 236
17.4
27,855
1,596,379
18.9
30,696
1,627, 522
17.1
28,390
1,658,665
17.0
28,783
1,689,808
17.9
30,833
1,720,952
17.9
31,367
1,748,102
17.2
30, 515
1,775,252
17.5
31,465
1,802, 402
31,725
17.3
1,829, 552
17.1
31,687
1,856,702
18.1
34,184
1,883, 852
2 18.0
29,731
1,656,157

OCCUPATIONAL

3,834
4,949
6,407
4,375
3,887
3,399
2,850
4,116
4,779
4,457
4,471
5,362
6,864
7,760
8,768
8,568
9,148
10,185
9,056
8,810
9,869
9,607
9,225
8,742
7,797
9,721
9,052
9,739
8,274
6,374
8,373

1891.
1892.

Death
Death
Number
Deaths, rate per exposed. Deaths. rate per
1,000.
1,000.
45
11.7
62
12.5
8.6
55
16.0
70
18.8
73
23.2
79
20.0
57
11.7
48
11.1
53
17.1
76
13.9
62
11.6
62
10.3
71
11.2
87
10.0
88
13.8
118
15.9
15.6
2,699
143
30.2
2,714
14.1
144
30.3
15.2
2,676
138
27.0
16.9
2,589
149
22.6
11.2
2,172
111
29.7
2,660
18.6
179
21.5
2,468
19.3
178
26.9
2,415
18.9
165
24.6
26.4
2,155
206
21 .1
22.3
1,895
217
23.6
1,654
22.3
202
32.9
21.2
1,369
206
19.2
1,249
25.7
213
28.6
26.2
874
167
42.1
1,165
46.7
391
25.6
782
17.4
576

Glass-bottle blowers.

COMPARATIVE

61928°— 22— Bull. 293-

Year or period.

Limestone cutters.

Sandstone cutters.

Granite cutters.

92

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

In this table the mortality from all causes fails to reflect the ex­
traordinary mortality from pulmonary tuberculosis or dust phthisis,
which suggests the absolute necessity of a detailed analysis to visual­
ize unfavorable tendencies, for during the period 1910-1914, which
may be looked upon as normal, the death rate of granite cutters was
21 per 1,000 as against 25 for sandstone cutters,' 18.6 for limestone
cutters, 13.3 for glass-bottle blowers, and 17.6 for the male population
of Massachusetts. The indicated differences fall far short of re­
flecting the true disparity in the mortality rates from both causes
or their influence upon the true life expectancy of granite cutters,
which is unquestionably much more serious than would be apparent
from a superficial and noncritical analysis.
Table 68 illustrates the striking and really extraordinary differ­
ences in tuberculosis disease frequency among granite, sandstone,
and limestone workers. It is shown that the tuberculosis mortality
of the granite cutters of Vermont per 100,000 has increased from
719.5 in 1905-1909 to 1,064.5 in 1915-1918, and that of the granite
cutters of New England from 611.6 to 1,056.7. During the same
period the mortality of sandstone cutters has increased from 910.5
to 1,029.9, while for limestone cutters the death rate has diminished
from 626.8 to 425.5. There was also a material decline during the
same period in the mortality of glass-bottle blowers, or from 381.1
to 265.9 per 100,000, while among the male population of Massachu­
setts 20 years of age and over the death rate from pulmonary tuber­
culosis diminished from 225.2 to 203.2. For practical purposes the
evidence is therefore entirely conclusive that the serious effects of
dust inhalation are practically limited to granite and sandstone cut­
ters and are increasing in severity. The primary cause of this dif­
ference is unquestionably the silica content of the dust inhaled, for,
according to the analysis of such dust samples as have been available
for the purpose, the proportion of silica in granite dust, as shown in
Table 69, is 72.96 per cent, and in sandstone dust 85.42 per cent,
while in limestone dust the proportion is only 1.22 per cent. Since
this question will receive further consideration, it need not here be
enlarged upon.®
a For a more extended discussion of this question see p. 108 et seq. It may be said in this connection
that it is to be hoped the Bureau of Mines will give full publicity to the data collected by the ascertainment
of actual shop conditions in the Barre district. A preliminary account of the method followed of deter­
mining by comparative tests the air dustiness of granite shops by means of the dust counter, the konimeter,
or the sugar tube, has been published in The Research Laboratory, the technical periodical of the Bureau
of Mines, under date of July, 1921. It is explained in this discussion that averages of all tests at Barre
“ show that the konimeter method indicates about 13 times as many dust particles as the dust counter, and
the sugar tubeabout 7 times as many as the konimeter.” These important differences in the results secured
by different methods clearly indicate the extreme urgency of such investigations being made by those best
qualified to make them. The following statement may be quotedin this connection: “ Very large variations
in degree of dustiness at any one plant are apparent. In all but two situations the numbers of particles
indicated by the sugar were much greater than those by the konimeter, and the numbers indicated by
the konimeter were greater than those by the dust counter. The lower result with the dust counter is due
partly to inability to observe some of the smaller particles at a magnification of 50 diameters. On the
other hand, the sugar-tube particles, counted at 110 diameter, were much more than those with the koni­
meter, counted at 200 diameter.”




TABLE 6 8 . —M O RTALITY FROM PULMONARY TUBERCULOSIS AMONG GRANITE CUTTERS OF TH E N E W ENGLAND STATES COMPARED W IT H

THAT OF SANDSTONE AND LIMESTONE CUTTERS AND GLASS-BOTTLE BLO W ERS OF THE UNITED STATES AND CANADA AND THE
ADULT MALE POPULATION OF MASSACHUSETTS, 1892 to 1920.
Granite cutters.

Male population of Massa­
chusetts (20 years of age
and over).

3 First nine months of 1920.

*1915-1917.

DATA,

2 Entire year of 1918.

MOETAUTY

New England.
Vermont.
Death
Death
Death Num­
Death Num­
NumPopula­
rate
Death bej ex­ Deaths. rate ber ex­ Deaths. rate ber ex­ Deaths. rate
Death Num­
Deaths. per
Num­
tion.
per
per
per
rate
rate
posed.
posed.
ber ex­ Deaths.
ber ex­ Deaths.
100,000.
100,000.
100,000. posed.
100,000.
per
per
posed.
100,000.
100,000. posed.
332.0
2,320
720,535
6
232.6
2,580
5
2,271
307.9
737,628
236.6
2,536
297.7
2,247
754,721
373.7
2,676
10
2,318
300.3
312.5
771,813
8
2,560
2,334
295.0
12
488.8
791,091
2,455
3
1,164
257.7
3,747
266.9
io
281.6
2,282
14
600.1
810,369
2,333
1,262
5
3,918
15
382.8
396.2
286.0
829,647
2,373
7
293.4
2,386
4,046
1,491
6
402.4
17
420.2
2,382
280.6
411.7
848,925
15
3,643
1,667
8
26
4,029
479.9
645.3
2,298
264.7
17
868,201
4,202
404.6
4,758
5
20
271.3
420.3
1,843
262.1
2,308
880,578
19
357.9
5,309
1,860
5
268.8
377.4
5,300
20
239.8
892,955
2,141
21
6,207
338.3
2,198
9
409.5
6,166
30
486.5
2,022
223.3
905,332
6,799
13
191.2
2,342
8
341.6
6,251
31
495.9
240.9
917,709
2,211
7,177
31
431.9
11
2,504
6,842
439.3
32
467.7
2,195
236.0
32
930,088
947.6
7,311
437.7
40
25
20
770.7
7,202
597.1
926.3
4,221
2,595
43
2,699
2,156
225.9
29
358. 3
954,510
8,093
35 1,289.6
19
2,714
4,245
20
471.1
2,938
8,049
646.7
49
608.8
2,336
238.6
36
417.1
978,932
8,631
24
896.9
4,315
30
695.2
2,676
3,046
25
820.7
7,569
46
607.7
2,207
220.0
8,384
393.6 1,003,354
33
4,434
22
2,881
811.1
496.2
22
763.6
7,316
56
765.4
21
2,589
2,127
28
207.0
9,035
309.9 1,027,776
26
552.5
541.3
3,134
19
606.2
38
7,798
2,172
12
4,803
487.3
8,854
35
2,252
939.8
4,618
15
324.8
395.3 1,052,198
3,296
27
819.2
7,888
214.Q
25
59
748.0
2,660
8,682
30
345.5 1,072,627
2,233
208.2
507.1
769.8
3,944
3,352
25
745.8
680.4
19
20
7,937
54
2,468
16
1,093,056
2,128
194.7
9,165
174.6
345.2
3,266
703.9
19
581.8
3,766
13
7,609
49
644.0
2,415
17
2,220
199.3
33
378.5 1,113,485
12
335.1
8,719
28
74
3,581
3,660
765.0
952.7
2,155
22 1,020.9
7,767
2,275
8,544
28
327.7
200.6
294.6
1,133,914
3,529
38 1,076.8
7,567
75
991.1
16
844.3
3,395
10
1,895
25
321.5 1,154,343
190.7
7,776
2,201
32
885.7
786.0
3,069
14
456.2
61
818.5
1,654
13
3,613
7,453
15
2,460
209.4
192.6 1,174,772
3,681
353.2
7,790
7,051
84 1,191.3
18 1,314.8
13
3,233
43 1,330.0
1,369
3,524
17
482.4
8,466
21
2,500
32 1,095.5
6,662
72 1,080. 8
12
960.8
248.0 1,195,201
209.2
2,921
1,249
6,425
20
26
953.4
2,416
10
413.9
2,727
59 1,191.0
874
10 1,144. 2
4,954
311.3
496.7
8,567
24
224.4
16
280.1 1,215,630
2,728
14 1,201.7
6,605
1,165
3,221
73 1,105.2
5
8,072
12
148.7
2,108
8 1,023.0
237.2
782
5
868.1
2,506
10
576
399.0
7,792
22
282.3 2,212,884
6,838
309.0
288.5
56
5,584
418.6 4,051,845 11,689
22
68
13,377
394.0 15,740
432.0
29,694
101
10,747
340.1 4,464,775 10,980
245.9
38
353.6 29,317
133
453.7
158
381.1 4,894,660 11,021
225.2
105
719.5 37,934
611.6 12,850
910.5 22,018
138
626.8 41,454
14,594
232
117
203.2
142
323.0 5,465,280 11,108
137
801.0 38,768
802.2 11,593
854.0 19,304
70
362.6 43,964
17,103
311
99
* 203. 2
54
425.5 30.457
81
265.9 <3,524,316 < 7,161
276 1,056.7
5,116
133 1,064.5 26,120
53 1.029.9 12;690
12,494

1 Exclusive of last three months of 1918.




Glass-bottle blowers.

OCCUPATIONAL

1892..................................
1893..................................
1894..................................
1895..................................
1896
1897..................................
1898.............................
1899 .
...
1900..................................
1901...........................
1902..
1903 ...............................
1904..................................
1905..................................
1906..................................
1907..................................
1908..................................
1909..................................
1910..................................
1911..................................
1912..................................
1913..................................
1914..................................
1915..................................
1916..................................
1917..................................
19181 .
1918 2................................
1919..................................
19203................................
1892-1894.........................
1895-1899.........................
1900-1904......................
1905-1909.........................
1910-1914.......................
1915-19181 .. .. ................

Limestone cutters.

COMPARATIVE

Year or period.

Sandstone cutters.

CO

94

DUST PH TH ISIS IN THE GKANITE-STONE INDUSTRY.
T able 6 9 .—CHEMICAL AN ALYSES OF GR AN ITE, SANDSTONE, AND LIM ESTONE.

Constituent.

Granite.

Silica (Si02).....................................................................................................
Alumina ( A I 2 O 3 ) ............................................................................................................................................
Soda (Na20 ) ....................................................................................................
Potash (K sO)..................................................................................................
Lime (CaO).....................................................................................................
Iron oxide (FeO )............................................................................................
Iron sesquioxide (Fe203).........................................................................
Magnesium oxide (MgO)..............................................................................
Calcium carbonate (CaCOg).........................................................................
Magnesium carbonate (MgCOs)..................................................................
Other elements...............................................................................................

Sandstone. Limestone.

Per cent.
72.96
15.04
4.05
3.76
1.48
.78
1.19
.26

Total..........................................................................................................

Per cent.
85.42
5.92
.70
.59
1.41
.23
2.44
.23

P er cent.
1.22
.46

.12

........... 96.37
1.37
2.87
.33

.57
100.09

99.81

99.87

A more detailed analysis of the mortality data by principal causes
of death, as shown in Table 70, emphasizes other marked variations in
the mortality experience which are in all probability also directly
attributable to differences in the mechanical and chemical properties
of the dust inhaled. It is shown that the death rate for granite cut­
ters from pneumonia during 1915-1918 was 201.6 per 100,000, for
sandstone cutters 310.9, and for limestone cutters 118.2. The differ­
ences are less marked for bronchitis and asthma, although in the case
of both of these diseases the death rates for granite cutters are
excessive.
7 0 .—M ORTALITY FROM SPECIFIED CAUSES AMONG GRANITE CUTTERS OF
THE N E W ENGLAND STATES COMPARED W IT H T H A T OF SANDSTONE AND LIME­
STONE CUTTERS AND GLASS-BOTTLE BLOW ERS OF TH E UNITED STATES AND
CANADA AND TH E ADULT MALE POPULATION OF MASSACHUSETTS, B Y PERI­
ODS OF Y E A R S.

table

Granite cutters.

Sandstone out­
ers.

Limestone cut­
ters.

Glass-bbttle
blowers.

Males of Massa­
chusetts.^ to
69 years of age).

Period.
Num­ Death Num­ Death Num­ Death Num­ Death Num­ Death
ber of rate per ber of rate per ber of rate per ber of rate per ber of rate per
deaths. 100,000. deaths. 100,000. deaths. 100,000. deaths. 100,000. deaths. 100,000.
Tuberculosis of the lungs.
1QAA—1QfU.
1905-1909....................
1910-1914 .................
1915-19181...................

133
453.7
232
611.6
311
802.2
290 1,044.3

117
910.5
99
854.0
53 1,029.9

138
70
54

626.8
362.6
425.5

101
158
142
81

340.1
381.1
323.0
265.9

10,592
10,653
10,805
6,997

247.4
225.0
204.5
2 207.0

27
37
51
50

90.9
89.2
116.0
164.2

5,568
5,570
5,870
3,805

130.1
117.6
111.1
2 112.6

1
3
6

3.4
7.2
13.6

718
570
467
187

16.8
12.0
8.8
2 5. 5

Pneumonia.
1ann 1Qnj.
1905-1909 .................
1910-1914
1915-1918K .................

29
32
49
56

98.9
84.4
126.4
201.6

18
23
16

140.1
198.4
310.9

27
23
15

122.6
119.1
118.2

Bronchitis.
1nnn 1QA/i
1905-1909
1910-1914
1915-19181..................

3
7
13
12

10.2
18. 5
33.5
43.2

3
2
2

23.3
17.2
38.9

1Exclusive of the last three months of 1918.




4
6
4

18.2
31.1
31.5

1915-1917.

COMPARATIVE OCCUPATIONAL MORTALITY DATA.

95

T able 7 0 .—M O R T A L IT Y FROM SPECIFIED CAUSES AMONG G R AN ITE CUTTERS OF
THE N E W ENGLAND STATES COMPARED W IT H T H A T OF SANDSTONE AND LIME­
STONE CUTTERS AND GLASS-BOTTLE BL O W ER S OF T H E U N ITED STATES AND
CANADA AND TH E A D U L T M ALE POPULATION OF MASSACHUSETTS, B Y PER I­
ODS OF Y E A R S—Concluded.

out­
Granite cutters. Sandstone
ers.

Limestone cut­
ters.

Glass-bottle
blowers.

Males of Massa­
chusetts (20 tp
69 years of age).

Period.
Num­ Death Num­ Death Num­ Death Num­ Death Num­ Death
ber of rate per ber of rate per ber of rate per ber of rate per ber of rate per
deaths. 100,000. deaths. 100,000. deaths. 100,000. deaths. 100,000. deaths. 100,000.
Asthma.
1900-1904
1905-1909....................
1910-1914....................
1915-19181...................

5
3
10
7

17.1
7.9
25.8
25.2

4
3
2

4
3
2

31.1
25.9
38.9

18.2
15.5
15.8

4
8
4

13.5
19.3
9.1

332
233
113
64

7.8
4.9
2.1
2 1.9

111.1
130.3
129.6
167.4

5,979
6,609
7,128
5,894

139.7
139.6
134.9
* 174.4

2,629
3,348
4,141
3,057

61.4
70.7
78.4
s 90.4

Organic diseases of the heart.
1900-1904
1905-1909....................
1910-1914....................
1915-19181...................

23
56
59
55

78.5
147. 6
152.2
198.0

17
16
6

132.3
138.0
116.6

24
26
18

109.0
134.7
141.8

33
54
57
51

Cancer and other malignant tumors.
1900-1904
1905-1909....................
1910-1914....................
1915-19181..................

4
11
24
17

13.6
29.0
61.9
61.2

2
5
4

15.6
43.1
77.7

8
10
8

1 Exclusive of the last three months of 1918.

36.3
51.8
63.0

8
9
29
23

26.9
21.7
66.0
75.5

2 1915-1917.

When compared with the male population of Massachusetts it is
shown in this table that the mortality of granite cutters during 19151918 was 201.6 for pneumonia as against 112.6 for Massachusetts; for
bronchitis the rate was 43.2 for granite cutters and only 5.5 for Mas­
sachusetts; for asthma it was 25.2 for granite cutters and 1.9 for
Massachusetts. Thus all of the nontubercular respiratory diseases,
as well as tuberculosis, rightly or wrongly diagnosed, show a mor­
tality figure materially in excess of the rates expected on the basis of
the State data perhaps most useful for comparative purposes. The
mortality from organic heart diseases was 198.0 for granite cutters, as
against 174.4 for Massachusetts, while the figure for cancer was, re­
spectively, 61.2 and 90.4.
To make the foregoing comparison as useful as possible Table 71
shows the mortality from 36 specified causes for the four occupational
groups considered and the adult male population of Massachusetts
for the period 1913 to 1917. The most significant fact in this table is
the excessive mortality from pulmonary tuberculosis among granite
cutters, shown to have been 1,002.7 per 100,000 against 973.3 for
sandstone cutters, 382.6 for limestone cutters, 295.4 for glass blowers,
and 208.4 for adult males of the State of Massachusetts.




T a b le 7 1 .—M O RTALITY FROM SPECIFIED CAUSES AMONG GRANITE CUTTERS OF THE N E W ENGLAND STATES COMPARED W IT H THAT OF
SANDSTONE AND LIMESTONE CUTTERS AND GLASS-BOTTLE BLOWERS OF THE UNITED STATES AND CANADA AN D THE AD U L T MALE
POPULATION OF MASSACHUSETTS, 1913 TO 1917.

Granite cutters.

Abridged
inter­
national
list

Sandstone cutters.

Limestone cutters.

Glass-bottle blow­
ers.

Cause of death,

number.1

1

2

3
4
5

6

10
11

12
13
14
15
16
17
18
19

20
21
22

23
24
26
27
28
29
34
35
36
37
38

Influenza
Other epidemic diseases
.
...........................
Tuberculosis of the lungs...................................................................
Tuberculous meningitis.....................................................................
Other forms of tuberculosis
Cancer and other malignant tumors..............................................
Simple meningitis...............................................................................
Cerebral hemorrhage and softening..................................................
Organic diseases of the heart.............................................................
Acute bronchitis..................................................................................
Chronic bronchitis
................................................................
Pneumonia...........................................................................................
Other diseases of the respiratory system (tuberculosisexcepted)
Diseases of the stomach (cancer excepted) ..................................
Appendicitis and typhlitis................................................................
Hernia and intestinal obstruction
....
Cirrhosis of the liver
..................
Acute nephritis and Bright’s disease ...........................................

Number
of
deaths.

Death
rate ner
100,000.

Number
of
deaths

Death
rate per
100,000.

Number
of
deaths.

Death
rate per
100,000.

Number
of
deaths.

Death
rate per
100,000.

Number
of
deaths.

2

5.5

2

24.0

2

11.6

6

14.5

541

9.8

1
1

2.7
2.7

1
1
1

12.0
12.0
12.0

1
2
1

5.8
11.6
5.8

.2
.2
.3
.6

3

8.2

1

12.0

1

5.8

10
9
16
35
1
53
240

1.0
4.3

17.4
382.6
17.4
11.6
58.0
17.4
98.6
139.1
17.4
11.6
104.3
46.4
23.2
40.6
17.4
46.4
156.5
11.6
173.9
34.8
179.7
29.0

1
122
2

2.4
295.4
4.8

31
4
28
51
1
1
58
13
9
4
3
13
52
6
42
14
80
19

75.1
9.7
67.8
123.5
2.4
2.4
140.4
31.5
21.8
9.7
7.3
31.5
125.9
14.5
101.7
33.9
193.7
46.0

1
409
11,533
165
529
4,875
155
4,229
9,226
87
265
5,963
1,740
717
688
488
871
6,031
36
6,777
1,628
13,470
272

7.4
208.4
3.0
9.6
88.1
2.8
76.4
166.7
1.6
4.8
107.8
31.4
13.0
12.4
8.8
15.7
109.0
.6
122.5
29.5
243.4
4.9

2 16.8

560

213.6

71,060

2 12.8

81
2
3
4
2
10
12
4

24.0
973.3
24.0
36.0
48.1
24.0
120.2
144.2
48.1

20
13
1
4

240.3
156.2
12.0
48.1

19.2
54.8
197.3
11.0

1
13
1
9
2
8
3

12.0
156.2
12.0
108.1
24.0
96.1
36.0

3
66
3
2
10
3
17
24
3
2
18
8
4
7
3
8
27
2
30
6
31
5

2 19.4

201

2 24.2

289

366
3
3
23
2
15
64
9
7
59
23

1,002.7
8.2
8.2
63.0
5.5
41.1
175.3
24.6
19.2
161.6
63.0

6

16.4

20

54.8

Violent deaths (suicide excepted)..................................................
Suicide..................................................................................................
Other defined diseases........................................................................
Diseases ill-defined or unknown......................................................

7
20
72
4

All causes.......................................................................................

710

1 Manual of the International List of Causes of Death, United States Bureau of the Census, Washington, D. C., 1916.
2 Death rate per 1,000.




d
d
H

U1

7

8
9

Males of Massachu­
setts (20 to 69
years of age).
Death
rate per
100,000.

w
w
HH

H

w
tH
QC

H
«

0

W

%
M
H
&
1
co
H

o

bJ
o
cj
U1
H
*1

97

COMPARATIVE OCCUPATIONAL MORTALITY DATA.
SWISS OCCUPATIONAL EXPERIENCE.

The most useful intensive data for comparative purposes are for
Switzerland and Holland. The data for Switzerland unfortunately
are only for the period 1879 to 1900, but the statistics are of such
exceptional interest, being available by divisional periods of life, that
it seems advisable to include the data in the present investigation.
These are very briefly referred to, as an illustration of the possibilities
of further inquiries in this direction rather than as regards their
comparable value, since the statistics have reference to industries
rather than to occupations. Table 72 exhibits the comparative
mortality from all causes among stonecutters, lime and brick burners,
gypsum, cement and asphalt workers, farmers, and all occupied
males in the Swiss Republic, first, for the period 1879 to 1890 and,
second, for the period 1889 to 1900. To be strictly comparable these
statistics have been standardized to eliminate minor divergencies
due to an abnormal age distribution, but without reference to such
standardization it is shown that the death rate has been consistently
high for stonecutters, being 29.4 per 1,000 of population during 18891900, as against 29.2 during 1879-1890. The standardized death rates
reduce these rates considerably, or, respectively, to 22.7 and 22.5.
There has therefore not been the increase in the mortality shown to
have taken place among American granite workers, but this is prob­
ably attributable to the lesser use of pneumatic tools at this com­
paratively early period of the stone-working industry.
The standardized death rate for lime and brick burners is a
very much lower rate, being 10 per 1,000 for the period 18891900 and for farmers it was also 10, while for gypsum, cement, and
asphalt workers the rate during the same period was only 9.4. The
necessity for standardization is clearly illustrated in the case of
farmers, for which the crude death rate was 21 per 1,000. For
occupied males generally the standardized rate decreased from 13.7
during 1879-1890 to 12.4 during 1889-1900.
T a ble 7 2 ,—M O RTALITY FROM A L L CAUSES AMONG TH E GRANITE CU TTERS OF
B A R R E , V T ., COMPARED W IT H T H A T OF T H E MALE POPULATION OF MASSA­
CHUSETTS AN D STONECUTTERS, LIME AN D BRICK BU R N E R S, GYPSUM, CEM ENT,
AND ASPH ALT W O R K E R S , FARM ERS, AND A L L OCCUPIED MALES OF SW IT ZE R ­
LAND, B Y AGE GROUPS.
[Experience of the Granite Cutters International Association of America; Ehe, Gebuxt und Tod in der
schweizerischen Bevolkerung, 1879-1890, Part III, Bern, 1903, p. 99; 1889-1900, Part V, Bern, 1916, p. 275.]
Granite cutters of Barre, Male population of Mas­ Stonecutters— Switzerland.!
sachusetts.
Vt.
1879-1890
1911-1917
1911-1917
Age at death.
Death
Num­
ber ex­ Deaths. rate per
1,000.
posed.
15 to 19 years.................
20 to 29 years.................
30 to 39 years.................
40 to 49 years.................
50 to 59 years.................
60 years and over.........

302
2,505
4,524
3, 563
1,263
173

14
34
97
76
27

5.6
7.5
27.2
60.2
156.1

Total........................
Standardized rates2

12,330

248

20.1
20.1

Popula­
tion.

Death Number
Death
Deaths. rate per exposed. Deaths. rate per
1,000.
1,000.
3,638
11,871
15, 312
19, 428
23, 608
64, 816

3.4
5.0
7.6
12.1
22.4
71.4

5,028
14,154
16,644
12,990
8,322
5, 460

28
112
269
383
369
670

5.6
7.9
16.2
29.5
44.3
122.7

9,008,009 138,673

15.4
10.7

62,598

1,831

29.2
22.5

1,070,611
2,356,512
2,017,626
1,600, 792
1,054, 755
907, 713

1 Inclusive of marble cutters.
2 Standardization based on age distribution of the granite cutters of Barre, \ t., 1911-1917.




98-

dust

PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

T able 7 2 .—M O R T A L IT Y FROM A L L CAUSES AMONG TH E G R AN ITE CUTTERS OF
B A R R E , V T ., COMPARED W IT H T H A T OF TH E M ALE PO PULATION OF MASSA­
CH USETTS AND STONECUTTERS, LIME A N D BR IC K B U R N E R S , GYPSUM, CEMENT,
A N D ASPH ALT W O R K E R S , FAR M ER S, AN D A L L OCCUPIED M ALES OF S W IT ZE R ­
L A N D , B Y AGE GROUPS-Concluded.

Stonecutters1— Swit1889-1900

Lime and brick burners— Switzerland.
1879-1890

1889-1900

Age at death.
Death
Number
Deaths. rate per exposed.
1,000.

Death Number
Num­
ber ex­ Deaths. rate per exposed.
posed.
1,000.

Death
Deaths. rate per
1,000.

5,130
15 to 19 years.................
20 to 29 years................. 15, 564
30 to 39 years................. 12, 828
40 to 49 years................. 12, 084
7, 944
50to 59 years.,.............
5, 022
60 years and over.........

26
108
195
372
383
639

5.1
6.9
15.2
30.8
48.2
127.2

6,270
11,106
9,480
8, 676
5,430
3, 636

18
51
85
102
151
379

2.9
4.6
9.0
11.8
27.8
104.2

6, 756
13,704
11,172
8, 994
5, 760
3,642

22
61
75
85
132
393

3.3
4.4
6.7
9.4
22.9
107.9

58, 572

1,723

29.4
22.7

44,598

786

17.6
12.0

50,028

768

10.4
15.0

Total........................
Standardized rat^s2

Gypsum, cement, and
asphalt workers—
Switzerland.
1889-1900

Farmers— Switzerland.
1879-1890

1889-1900

15 to 19 years...............
20 to 29 years...............
80 to 39 years.................
40 to 49 years...............
50 to 59 years.................
60 years and over.........

3, 864
12,336
10, 398
6, 606
3,186
1,200

14
57
73
71
62
66

3.6
4.6
7.0
10.7
19.5
55.0

647, 658
955, 080
775, 296
789, 696
735, 438
746, 382

2,214
5, 238
5, 895
9, 514
15, 848
59, 857

3.4
5.5
7.6
12.0
21.5
80.2

614,220
958, 944
757, 458
723, 306
694, 416
785, 994

2,079
4,807
5, 322
7, 898
14,500
60, 460

3.4
5.0
7.0
10.9
20.9
76.9

Total........................
Standardized rates2

37, 590

343

9.1
9.4

4, 649, 550

98, 566

21.2
10.8

4, 534, 338

95, 066

21.0
10.0

All occupied males— Switzerland.
i\gc ell U.t5diLll*

1879-1890

15 to 19 years...............................................................
20 to 29 years....
................................................
30 to 39 years................................. .............................
40 to 49 vears................................................................
50 to 59 years................................................................
firt vfiars and over. _______________________ ______

____ __

Total
Standardized rates2

...................

1889-1900

7,477
1, 613, 832
2, 618, 370 19, 721
2,186,556 22,533
1,917,840 29,720
1,505, 502 39, 232
1, 484, 556 117, 866

4.6
7.5
10.3
15.5
26.1
79.4

1, 763,142
7, 621
3, 056, 298 19, 478
2,408,964 21,403
1,963,116 27, 633
1, 552, 530 39, 812
1,612, 398 122,462

4.3
6.4
8.9
14.1
25.6
75.9

11,326, 656 236, 549

20.9 12,356,448 238,409
13.7

19.3
12.4

1Inclusive of marble cutters.
2 Standardization bised on age distribution of the granite cutters of Barre, Vt., 1911-1917.

A similar comparison of the mortality from pulmonary tuberculosis
is made in Table 75, which also can only be referred to very briefly,
since it would obviously be to small purpose to base a conclusion upon
data which have reference to a period when trade conditions were
probably much at variance with those prevailing at the present time.
It is shown, however, that the standardized death rate from pulmo­
nary tuberculosis among stonecutters increased in the two periods
1879-1890 and 1889-1900 from 896.2 to 911.7 per 100,000. These rates
compare with a standardized death rate for the granite cutters of
Barre, Vt., for 1911-1917, of 1,184.1 per 100,000. The corresponding
rate for the adult male population of Massachusetts was only 207.7.
For lime and brick burners the standardized rate diminished from
280.3 for 1879-1890 to 225.9 for 1889-1900, while for gypsum, cement,
and asphalt workers for the period 1889-1900 the rate was 210.2.
For the farming population of Switzerland the rates diminished from
182.9 for 1879-1890 to 175.3 for 1889-1900, while for all occupied
males the rate decreased from 344.8 to 312.3.




99

COMPARATIVE OCCUPATIONAL MORTALITY DATA.

These statistics therefore in a general way confirm the conclusions
based upon the granite-cutters’ experience of North America. It is
to be hoped that sometime in the near future later statistics will be
made available through the Swiss statistical bureau.
7 3 . — M O R T A L IT Y FROM PU L M O N A R Y TUBERCULOSIS AMONG G R ANITE CUT­
TERS OF B A R R E , V T ., COMPARED W IT H T H A T OF TH E M ALE POPULATION OF MAS­
SACHUSETTS AND STONE CU T T E R S, LIME AND BR IC K B U R N ER S, GYPSUM, CEMENT,
AND ASP H A LT W O R K E R S, FAR M ER S, AND A L L OCCUPIED MALES OF SW IT ZE R LA N D ,
B Y AGE GROUPS.

T able

[Experience of the Granite Cutters’ International Association of America; Ehe Geburt und Tod in der
scnweizerischen Bevolkerung, 1879-1890, Part III, Bern, 1903, p. 103; 1889-1900, Part V, Bern, 1916, p. 283.]
Granite cutters of
Barre, Vt.
1911-1917

Male population of Massa­
chusetts.
1911-1917

Stonecutters1— Switzer­
land.
1879-1890

Age at death.
Num­
Death
ber ex­ Deaths. rate per
posed.
100,000.
15 to 19 years.................
20 to 29 vears.................
30 to 39 years.................
40 to 49 years.................
50 to 59 years............
60 years and over.........

302
2,505
4,524
3,563
1,263
173

Total........................
Standardized rates2

12,330

Death
Death
Deaths. rate per Number Deaths. rate per
100,000. exposed.
100,000.

Popula­
tion.

10
399. 2
17
375.8
60 1 684.0
49 3,879. 6
10 5,780. 3

1,070,611
2,356,512
2,017,626
1,600, 792
1,054,755
907,713

890
4,109
4,349
3,655
2,345
1,559

83.1
174.4
215.6
228.3
222. 3
171.8

5,028
14,154
16,-644
12,990
8,322
5,460

6
40
133
182
98
66

119.3
282.6
799.1
1,401.1
1,177.6
1,208.8

146 1,184.1
1,184.1

9,008,009

16,907

187. 7
207.7

62,598

525

838.7
896.2

Stonecuttersx—Swftzerland.
1889-1900

Lime and brick burners—Switzerland.
1S79-1890

1889-1900

Death Number
Num­
Death
Death
ber ex­ Deaths. rate per Number Deaths. rate per exposed.
Deaths. rate per
exposed.
100,000.
posed.
100,000.
100,000.
15 to 19 years.................
20 to 29 years.............
30 to 39 years.................
40 to 49 years...............
50 to 59 years...........
60 years and over........

5,130
15,564
12,828
12,084
7,944
5,022

3
58.5
53
340. 5
693. 8
89
175 1,448. 2
119 1,498. 0
49
975.7

6,270
11,106
9,480
8,676
5,430
3,636

3
20
37
21
14
7

47.8
180.1
390. 3
242.0
257. 8
192. 5

6,756
13,704
11,172
8,994
5, 760
3,642

4
23
27
18
23
12

59.2
167.8
241.7
200.1
399.3
329.4

Total........................
Standardized rates2

58, 572

488

833.2
911.7

44,598

102

228.7
280.3

50,028

107

213.9
225.9

Gypsum, cement and
asphalt workers—
Switzerland.
1889-1900

Farmers—Switzerland.
1879-1890

1889-1900

15 to 19 years...............
20 to 29 years.................
30 to 39 vears.................
40 to 49 years...............
50 to 59 years.................
60 years and over.........

3,864
12, 336
10, 398
6,606
3,186
1,200

3
19
18
16
12
4

77.6
154.0
173.1
242. 2
37G.6
333. 3

647,658
955,080
775,296
789,696
735,438
746,382

437
1,408
1,441
1,554
1,668
1,611

67.5
147.4
185.9
196.8
226.8
215.8

614,220
958,944
757,458
723, 306
694, 416
785,994

436
1,353
1,354
1,347
1,537
1,569

71.0
141.1
178.8
186.2
221.3
199.6

Total........................
Standardised rates2

37,590

72

191.5
210. 2

4,649,550

8,119

174.6
182.9

4, 534,338

7,596

167.5
175.3

All occupied males—Switzerland.
Age al ueam.

1879-1890

15 to 19 years................................................................ 1,613,832
20 to 29 years................................................................ 2,618,370
30 to 39 years................................................................ 2,186,556
40 to 49 years................................................................ 1,917,840
50 to 59 years................................................................ 1,505, 502
60 vears and over_______________________________ 1,484,556
Total_____________
Standardised rates 2

11,326,656

2,101
7,962
8,008
7,000
5,305
4,126
34,502

1889-1900
130.2
304.1
363. 2
365! 0
352. 4
277.9

1,763,142
3,056,298
2,408,964
1,963,116
1,552, 530
1,612, 398

2,161
7,880
7,604
6,824
5,597
4,375

122.6
257.8
315.6
347.6
360.5
271.3

304.6 12,356,448
344. 8

34,441

278.7
312.3

1 Inclusive of marble cutters.
2 Standardization based on the age distribution of the granite cutters of Barre, Vt., 1911-1917.




100

DUST PH TH ISIS IK TH E GRANITE-STONE INDUSTRY.
DUTCH OCCUPATIONAL EXPERIENCE.

The data for the Netherlands are available for the period 1908 to
1911 and therefore of more recent date. They are limited to glass
cutters, glass blowers, stonecutters, plasterers, masons, carpenters,
painters, and paper hangers. According to Table 74 the standardized
mortality rate per 1,000 from all causes was 19.7 for the granite
cutters of Barre, Vt., and 28.5 for glass cutters, 7.6 for glass blowers,
16.6 for stonecutters, 6.4 for plasterers, 5.9 for masons, 6.7 for
carpenters, 7.5 for painters, and 7.8 for paper hangers in the Nether­
lands. The exceptionally high mortality of glass cutters is in part
explained by the very limited experience, probably insufficient to
yield thoroughly trustworthy results, but with this exception and
that of stonecutters, the mortality of granite cutters is more than
twice the mortality from all causes among any other occupation
more or less exposed to dust or other occupational hazards.
TABLE 74»—M O R T A L IT Y FROM A L L CAUSES AMONG GR AN ITE CUTTERS OF B A R R E ,
V T ., COMPARED W IT H T H A T OF SPECIFIED OCCUPATIONS IN TH E M ANUFACTURING
AN D M ECHANICAL INDU STR IES OF TH E N E T H E R L A N D S.
[Experience of the Granite Cutters’ International Association of America; Die Sterblichkeit nachdem
Beruf in den Niederlanden, 1908-1911, by Sanitatsrat Dr. Prinzing, Ulm. Archiv fur Soziale Hygiene
und Demographie, Leipzig, 1919, vol. 13, Nos. 1 and 2, pp. 43-97.]
Glass industry—Netherlands.
1908-1911

Granite cutters of
Barre, Vt.
1911-1917

Glass cutters.

Glass blowers.

Age at death.
Death
Death Number
Death
Number
Number
Deaths. rate per exposed. Deaths. rate per
per
exposed. Deaths. rate
1,000.
1,000. exposed.
1,000.
18 to 24 years.................
25 to 34 years.................
35 to 44 years.................
45 to 54 years.................
55 to 64 years

1,137
3,573
4,438
2,484
454

2
23
67
93
53

1. 8
6. 4
15.1
37. 4
116.7

540
572
236
88
36

2
4
3
9

3.7
7.0
12.7
102. 3

2,040
1,652
1,072
480
184

9
11
5
5
6

4.4
6.7
4.7
10.4
32.6

Total........................
Standardized rates1. .

12,086

238

19.7
19.7

1,472

18

12.2
28.5

5,428

36

6.6
7.6

Stonecutters*—N etherlands.
i

Building trades—Netherlands.
1908-1911
Plasterers.

Masons.

24 years.............
34 years.................
44 years.................
54 years.................
64 years.................

2,424
2,596
1, 412
1,368
760

7
16
27
37
40

2. 9
6. 2
19.1
27.0
52.6

4,216
4,824
3,772
3,380
2,060

10
22
14
38
60

2.4
4.6
3.7
11.2
29. 1

17,156
21,088
15,660
15,152
10,632

58
78
72
143
260

3.4
3.7
4.6
9.4
24.4

Total........................
Standardized rates1

8, 560

127

14. 8
16.6

18, 252

144

7.9
6.4

79, 688

611

7.7
5.9

18 to
25 to
35 to
45 to
55 to

Building trades—Netherlands.
1908-1911
Painters and decorators.

Carpenters.

Paper hangers.

18 to 24 years.................
25 to 34 years.................
35 to 44 years.................
45 to 54 years.................
55 to 64 years.................

58,816
45, 800
33, 092
33, 644
21, 844

216
209
187
330
536

3. 7
4.6
5.6
9. 8
24.5

27,728
26,612
19, 452
14,616
8,504

115
135
107
186
226

4.1
5.1
5.5
12.7
26.6

5,616
5,500
4,584
2,996
1, 584

20
25
31
33
59

3.6
4.5
6.8
11.0
37.2

Total........................
Standardized rates1

193,196

1,478

7.6
6. 7

96,912

769

7.9
7.5

20, 280

168

8.3
7.8

1 Standardization based on the age distribution of the granite cutters of Barre, V t., 1911-1917.
2 Inclusive of marble cutters.




COMPARATIVE OCCUPATIONAL MORTALITY DATA.

101

The corresponding mortality from pulmonary tuberculosis is shown
in Table 75. This table yields practically the same results as shown
by other comparative data, the standardized death rates from tuber­
cular disease having been 1,191.5 per 100,000 for the granite cutters
of Vermont, 169. 8 for plasterers, 154.4 for masons, 222.1 for carpen­
ters, 222,9 for painters, and 315.6 for paper hangers.
7 5 __ M O R T A L IT Y FROM PU L M O N A R Y TUBERCULOSIS AM ONG TH E G R A N IT E
CUTTERS OF B A R R E , V T ., COMPARED W IT H T H A T OF SPECIFIED OCCUPATIONS
IN THE M AN UFACTURING AN D M ECHANICAL IN D U STR IES OF TH E N E T H E R L A N D S .

T a b le

[Experience of the Granite Cutters’ International Association of America; Die Sterblichkeit, nach demBeruf
in den Niederlanden, 1908-1911, by Sanitatsrat Dr. Prinzing, Ulm. Archiv fur Soziale Hygiene und
Demographie, Leipzig, 1919, vol. 13, Nos. 1 and 2, pp. 43-97.
Glass industry—Netherlands.
1908-1911

Granite cutters of
Barre, Vt.
1911-1917

Glass cutters.

Age at death.

Glass blowers.

Death
Death
Death
Number
per Number Deaths. rate per Number Deaths. rate per
exposed. Deaths. rate
exposed.
100,000. exposed.
100,000.
100,000.
18 to 24 years.................
25 to 34 years.................
S5to44 y e a r s ...,.........
45 to 54 years.................
55 to 64 years.................

1,137
3,573
4,438
2, 484
454

Total........................
Standardized rates 1

12, 086

14
391. 8
43
968.9
59 2,375.2
28 6,167. 4

540
572
236
88
36

144 1,191. 5
1 ,191. 5

1, 472

2
370.4
3
524.5
2
847.5
5 5, 681. 8
12

815.2
1,698. 4

2,040
1,652
1,072
480
184

2
5
2
3
1

98.0
302. 7
186.6
625. 0
543. 5

5, 428

13

239.5
331.6

Building trades— Netherlands.
1908-1911

Stonecutters3—N etherlands.
1908-1911

Masons.

Plasterers,
18 to 24 vears.,.............
25 to 34 years...............
35 to 44 vears.... ...........
45 to 54 years.................
55 to 64 years................. i

2,424
2, 596
1, 412
1, 368
760

2
82.5
9
346. 7
15 1, 062. 3
18 1, 315. 8
13 1, 710. 5

Total........................
Standardized rates 1

8,560

57

665.9
841.1

4,216
4,824
3, 772
3, 380
2,060

5
12
1
11
7

118.6
248. 8
26.5
325.4
339.8

17,156
21, 0S8
15, 660
15, 152
10, 632

22
28
24
26
31

128.2
132. 8
153. 2
171.6
291.6

18,252

36

197.2
169.8

79, 688

131

164.4
154,4

Building trades— Netherlands.
1908-1911
Carpenters.

Painters and decorators.

Paper hangers.

18 to 24 years.................
25 to 34 years...............
35 to 44 years.................
45 to 54 years.................
55 to 64 years.................

58, 816
45, 800
33, 092
33, 644
21,844

107
101
76
72
67

181.9
220.5
229.7
214.0
306.7

27, 728
26,612
19, 452
14, 616
8,504

59
65
37
36
24

212.8
244.2
190. 2
246.3
282.2

5,616
5,500
4,584
2,996
1, 584

10
16
16
8
15

178.1
290. 9
349. 0
267.0
947.0

Total........................
Standardized rates1

193,196

423

218.9
222.1

96, 912

221

228. 0
222.9

20,280

65

320. 5
315.6

1 Standardization based on the age distribution of the granite cutters of Barre, Vt., 1911-1917.
3 Inclusive of marble cutters.

The statistics for the Netherlands are fortunately also available
for nontuberculous respiratory diseases. The facts are shown in
Table 76, but they need not be further enlarged upon than to say
that the standardized mortality of granite cutters of Vermont from
this group of causes was 264.8 per 100,000, as against 175.2 for stone­
cutters of the Netherlands, 71.2 for plasterers, and 79.1 for masons.




102

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

7 6 .—M O R T AL IT Y FROM NONTUBERCULOUS R E SP IR A T O R Y DISEASES AM ONG
T H E G R ANITE CUTTERS OF B A R R E , VT ., COMPARED W IT H T H A T OF SPECIFIED
B U ILD IN G TRADES OF TH E N E T H E R L A N D S, B Y A G E GROUPS.

T able

[Experience of the Granite Cutters’ International Association of America; Die Sterblichkeit nach dem
Beruf in den Niederlanden, 1908-1911, by Sanitatsrat Dr. Prinzmg, Ulm. Archiv fur Soziale Hygiene
und Demographie, Leipzig, 1919, vol. 13,*Nos. 1 and 2, pp. 43-97.]

Granite cutters of Barre, V t.
1911-1917
Age at death.
Number
exposed.

Deaths.

Death rate
per 100,000.

18 to 24 years............................................................................................
25 to 34 years............................................................................................
35 to 44 years............................................................................................
45 to 54 years............................................................................................
55 to 64 years............................................................................................

1,137
3,573
4,438
2,484
454

2
10
11
9

56.0
225.3
442.8
1,982.4

Total...................................................................................................
Standardized rates1...............................................................................

12,086

32

264. 8
264.8

Stonecutters 3—Nether­
lands.
1908-1911

Plasterers—N etherlands.
1908-1911

Masons—N etherlands.
1908-1911

Age at death.
Death
Death
Death
Number
Number
rate per Number
exposed. Deaths. 100,000. exposed. Deaths. rate per exposed. Deaths. rate per
100,000.
100,000.
18 to 24 years.................
25 to 34 years.................
35 to 44 years.................
45 to 54 years.................
55 to 64 years.................

2,424
2,596
1,412
1,368
760

1

41.3

3
4
7

212. 5
292. 4
921. 0

Total........................
Standardized rates1

8,560

15

175. 2
175.2

4,216
4,824
3,772
3,380
2,060

1
2
1
6
5

23. 7
41. 5
26. 5
177. 5
242. 7

17,156
21,088
15,660
15,152
10, 632

2
6
9
23
47

11.7
28.4
57.5
151. 8
442.1

18,252

15

82. 2
71.2

79,688

87

109.2
79.1

and decorators—
Carpenters—N etherlands. Painters
Netherlands.
1908-1911
1908-1911
18 to 24 years.................
58,816
25 to 34 years.................
45,800
33,092
................. 35 to
44 years
45 to 54 years.................
33,644
21, 844
55 to 64 years.................
Total........................
Standardized rates1

193,196

10
18
24
42
97

17.0
39. 3
72. 5
124. 8
444. 1

27,728
26,612
19,452
14,616
8,504

191

98. 9
81.8

96,912

3
8
9
19
41
80

10.
30.
46.
130.
482.

Paper hangers—Nether­
lands.'
1908-1911

8
1
3
0
1

5,616
5,500
4, 584
2,996
1,584

2
4
2

43.6
133. 5
126.3

82. 5
72.2

20,280

8

39.4
49.3

1
1 Standardization based on the age distribution of the granite cutters of Barre, V t., 1911-1917.
2Inclusive of marble cutters.

Summarizing the rates for all the occupations for which the infor­
mation is available for the period 1908 to 1911, it is shown by Table
77 that for occupations with exposure to inorganic dust the mor­
tality from pulmonary tuberculosis was 635.0 per 100,000, for occu­
pations with exposure to organic dust 231.0, and for occupations
carried on in the open air only 163.0. The differences are less marked
in the case of nontuberculous respiratory diseases, having been,
respectively, 206.0 for inorganic dust, 151.0 for organic dust, and
136.0 for open-air occupations. These statistics are derived from
an extremely valuable discussion of the occupational mortality of
the Netherlands by Sanitary Councillor Dr. Prinzing, a leading
German authority on the subject.




103

COMPARATIVE OCCUPATIONAL MORTALITY DATA.

OCCUPATIONAL M O R T A L IT Y IN THE N E T H E R L A N D S FROM PU L M O N A R Y
TUBERCULOSIS, NONTUBERCULOUS R E SP IR A T O R Y DISEASES, AN D A L L CAUSES,
1908 TO 1911, CLASSIFIED ACCORDING TO E X P O SU R E TO DUST.

T able 7 7 .—

[Die Sterblichkeit naeh dem Beraf in den Niederlanden, 1908-1911, by Sanitatsrat by Dr. Prinzing, Ulm.
Arcliivfur Sozial Hygiene und Demographie, vol. 13, Nos. 1 and 2, p. 96.]
Standardized death rates, per 100,000
exposed, for all ages from—
Occupational group.
Pulmonary
tuberculosis.
Occupations with exposure to:
Inorganic dusts..........................................................................
Organic dusts............................................................................
Open-air occupations......................................................................

635.0
231.0
163.0

Nontuberculous
respiratory
All causes.
diseases.
206.0
151.0
136.0

1 15.5
1 8.9
18.1

1 Rate per 1,000 exposed.

ENGLISH OCCUPATIONAL MORTALITY STATISTICS.

The following table is included as a matter of convenient reference,
particularly suggestive of the statistical methods of presentation
most likely to prove useful for practical purposes. The first part of
the table shows the mortality from all causes, the second the mor­
tality from pulmonary tuberculosis, and the third the mortality from
nontuberculous respiratory diseases.
There are no later official statistics for England and Wales than
1900-1902. The data for this period are compared with the preced­
ing inquiry for 1890-1892. The rates have been recalculated and
standardized on the basis of the Barre granite-cutters’ experience
for 1911-1917.
M O RTALITY FROM A L L CAUSES, PULM ONARY TUBERCULOSIS, AN D N O N ­
TUBERCULOUS R ESPIR ATO R Y DISEASES, AMONG TH E G RANITE CUTTERS OF
BA R R E , V T ., COMPARED W IT H TH AT OF SPECIFIED OCCUPATIONS IN TH E M A N U ­
FACTURING AND MECHANICAL INDUSTRIES OF ENGLAND AND W ALES, B Y AG E
GROUPS.

T a b l e 7 8 .—

[Experience of the Granite Cutters’ International Association of America; Supplements to the Fifty-fifth
and Sixty-fifth Annual Reports of the Registrar General of Births, Deaths, and Marriages in England
and Wales, Part II, London, 1897 and 1908.]
A L L CAUSES.

Age at death.

Granite cutters of Barre,
Vt.
1911-1917

Stone and slate quarriers—England and Wales.
1890-1892

Death
Number Deaths. rate per Number
exposed.
exposed.
1,000.
15 to 19 years.............
20 to 24 years.............
25 to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 years.............
65 years and over.......
Total....................
Standardized rates1

302
1,015
3,573
4,438
2,484
454
64
12,330

2
23
67
93
53
10
248

2.0
6.4
15.1
37.4
116. 7
156. 2
20.1
20.1

16,329
18,414
37,287
33,120
24,045
13,185
5, 475
14'7,855

1900-1902

Death Number
Deaths. rate per exposed.
1,000.
55
104
277
480
608
681
793
2,998

3.4
5.6
7.4
14.5
25.3
51.6
144.8
20.3
15.7

Tin miners—England and Wales.
1890-1892
15 to 19 years.............
20 to 24 years.............
25 to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 years.............
65 years and over___
Total......... .
Standardized rates1.

7,092
4,836
5,829
3,492
3,042
2,088
786
27,165

21
34
47
50
101
138
143
534

4,032
2,895
4,548
3,462
2,142
1,344
549
18,972

6
16
61
94
83
97
122
479

64
139
258
382
611
661
724
2,839

1.5
5.5
13.4
27.2
38.7
72.2
222.2
25.2
25.8

1,989.
2,325
3,705
3,336
2,718
2,028
726
16,827

6
15
35
45
65
135
178
479

i Standardization based on the age distribution of the granite cutters of Barre, V t., 1911-1917.




2.6
4.5
4.9
8.8
18.1
34.4
94.2
13.4
10.4

Lead miners—England and
Wales.
1890-1892

1900-1902
3.0
7. 0
8. 1
14.3
33.2
66. 1
181.9
19.7
18.3

24,282
30,906
52,494
43,467
33,705
19,206
7,683
211,743

Death
Deaths. rate per
1,000.

3.0
6.5
9.4
13.5
23.9
66.6
245.2
28.5
16.8

104

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.

T able 7 8 .—M O R T A L IT Y FROM A L L CAUSES, PU L M O N A R Y TUBERCULOSIS, AN D N ON T U B E R C U L O U S R E SP IR A T O R Y DISEASES, AMONG T H E G R AN ITE CU TTERS OF
B A R R E , V T ., COMPARED W IT H T H A T OF SPECIFIED OCCUPATIONS IN T H E M ANU­
FAC T U R IN G A N D M ECH ANICAL INDU STR IES OF EN G LAN D A N D W A LE S, B Y A G S
GROUPS—Continued.
AL Ii CAUSES—Concluded.

Lead miners— England
and Wales.
1900-1902

&gd at death.

Ironstone miners— England and Wales.
1890-1892

1900-1902

15 to 19 years.............
20 to 24 years.............
25 to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 years.............
65 years and over —

1,302
1,662
3,243
2,478
2,295
1,383
621

8
8
24
32
40
70
134

6.1
4.8
7.4
12.9
17.4
50.6
215.8

6,732
7,674
13,791
12,216
8,385
3,696
975

23
35
82
100
143
1S&
144

3.4
4.6
5.9
8.2
17.1
33.3
147.7

4,869
6,984
13,104
10,422
8,583
4,827
1,506

15
21
70
69
105
135
14,8

3.1
3.0
5.3
6.6
12.2
28.0
98.3

Total......, ............
PfavndftT'diZPd rfvt-fiS1-

12,984

316

24.3
13.9

53,469

650

12.2
10.5

50,295

563

11.2
8.2

Coal miners—-England and Wales.

Cutlers and scissors
makers—England and
Wales.
1890-1892

1900-1902

1890-1892
283,536
249,525
380,355
265,098
162,981
80,403
25,677

1,082
1,402
2,391
2,552
3,165
3,521
3,760

3.8
5.6
6.3
9.6
19. 4
43.8
146.4

307,785
301,512
510,879
345,939
224,634
107,454
30,003

985
1,347
2,522
2,645
3,295
3,866
4,195

3.2
4.5
4.9
7.6
14.7
36.0
139.8

8,067
7,368
11,619
9,963
7,866
4,086
2,208

19
40
99
208
280
246
302

2.4
5.4
8.5
20.9
35.6
60.2
136.8

Total.................... 1,447,575
Standardized rates1.

17,873

12.3
12.1

1,828,206

18,855

10.3
9.7

51,177

1,194

23.3
20.6

15 to 19 years.............
20 to 24 years.............
25 to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 years.............
65 years and over___

Cutlers and scissors
makers—England and
Wales.
1900-1902

File makers— England and Wales.
1890-1892

1900-1902

15 to 19 years.............
20 to 24 years.............
25 to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 years.............
65 years and over —

5,466
4,941
10,818
8,952
7,233
4,764
1,944

7
19
82
152
231
220
219

1.3
3.8
7.6
17.0
31.9
46.2
112. 7

3,597
2,757
5,049
4,632
3,345
1,596
699

6
19
56
121
134
113
103

1.7
6.9
11.1
26.1
40.1
70.8
147.4

2,676
2,253
4,116
3,765
3,150
1,845
693

7
11
40
67
108
92
69

2.6
4.9
9.7
17.8
34.3
49.9
99.6

Total....................
Standardized rates1.

44,118

930

21.1
17.4

21,675

552

25.5
24.7

18,498

394

21.3
18.9

A ll occupied males— England and Wales.
Age at death.
1890-1892
4,185,732 10,694
3,668,295 18,581
6,147,030 44,821
4,714,230 58,613
3,426,093 70,779
2,072,076 75,971
1,178,679 120,598

1900-1902
2.6
5.1
7.3
12.4
20. 7
36.7
102.3

4,526,391 11,048
4,336,335 19,132
7,337,565 44,101
5,668,233 57,911
4,024,074 71,365
2,424,456 75,180
1,202,520 106,296

2.4
4.4
6.0
10.2
17.7
31.0
88.4

15.8 29,519,574 385,033
T otal...................................................................... 25,392,135 400,057
13.1
Standardized rates1 ..................................................

13.0
11.0

15 to 19 years.................................................................
20 to 24 years................................................................
25 to 34 years................................................................
35 to 44 years.................................................................
45 to 54 years................................................................
55 to 64 years................................................................
65 years and over.........................................................

i Standardization based on the age distribution of the granite cutters of Barre, V t., 1911-1917.




105

COMPARATIVE OCCUPATIONAL MORTALITY DATA.

T able 7 8 .—M O R T A L IT Y FROM A L L CAUSES, PU LM O N A R Y TUBERCULOSIS, AN D NON­
T UBERCULOUS R E SP IR A T O R Y DISEASES, AM ONG T H E G R AN ITE CUTTERS OF
B A R R E , V T ., COMPARED W IT H T H A T OF SPECIFIED OCCUPATIONS IN T H E M ANU­
FACTURING AN D M ECHANICAL INDU STR IES OF EN G LAN D AN D W A LE S, B Y AGE
GROUPS— Continued.
P U LM O N AR Y TUBERCULOSIS.

Granite cutters of Barre,
Vt.
1911-1917

Stone and slate quarriers—England and Wales.
1890-1892

1900-1902

Age at death.
Death Number
Number
per
exposed. Deaths. rate
100,000. exposed.
15 to 19 years.............
20 to 24 years.............
25 to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 years.............
65 years and over___

302
1,015
3,573
4,438
2,484
454
64

Total.....................
Standardized rates

12,330

14
391.8
43
968.9
59 2,375.2
28 6,167.4
2 3,125. 0
. 146 1.184.1
1.184.1

Death
Number
Deaths. rate per exposed.
100,000.

16,329
18,414
37,287
33,120
24, 045
13,185
5, 475

11
24
93
158
151
79
20

67.4
130.3
249.4
477.1
628.0
599.2
365.3

24,282
30,906
52,494
43,467
33,705
19,206
7, 683

13
53
79
92
145
80
25

53.5
171.5
150.5
211.6
430.2
416.5
325.4

147, 855

536

362.5
407.2

211,743

487

230.0
239.0

Tin miners—England and Wales.
1890-1892
15 to 19 years.........
20 to 24 years.............
25 to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 years.............
65 years and over___

7,092
4,836
5, 829
3,492
3,042
2,088
786

Total....................
Standardized rates *

27,165

Death
Deaths. rate per
100,000.

Lead miners— England and
Wales.
1890-1892.

1900-1902

98.7
7
330.8
16
20
342.5
21
601.4
41 1.347.8
38 1.819.9
17 2,162.8

4,032
2,895
4, 548
3, 462
2,142
1,344
549

1
5
32
41
36
23
10

24.8
172.7
703.6
1.184.3
1,680.7
1.711.3
1,821.5

1,989
2,325
3, 705
3,336
2,718
2,028
726

3
7
16
21
20
19
4

150.8
301.1
431.8
629.5
735.8
936.9
551.0

589.0
695.7

18, 972

148

780.1
1,059. 5

16, 827

90

534.9
564.6

160

Lead miners—England
and W ales.
1900-1902

Ironstone miners—England and Wales.
1890-1892

1900-1902

15 to 19 yea rs.............
20 to 24 years.............
25 to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 years.............
65 years and over___

1,302
1,662
3,243
2,478
2,295
1,383
621

2
2
15
6
12
10
4

153.6
120.3
462.5
242.1
522.9
723.1
644.1

6, 732
7,674
13, 791
12,216
8,385
3, 696
975

10
6
18
21
14
4
2

148.5
78.2
130.5
171.9
167.0
108.2
205.1

4, 869
6,984
13,104
10,422
8, 583
4, 827
1,506

4
4
16
15
17
18
3

82.2
57 3
122.1
143.9
198.1
372.9
199.2

Total....................
Standardized rates1

12, 984

51

392.8
354.3

53, 469

75

140.3
147.7

50,295

77

153.1
149.1

Coal miners—England and Wales.
1890-1892

Cutlers and scissors mak­
ers— England and Wales.
1890-1892

1900-1902

283, 536
249, 525
380, 355
265, 098
162, 981
80, 403
25, 677

165
346
460
376
338
179
52

58.2
138.7
120.9
141.8
207.4
222.6
202.5

307,785
301, 512
510, 879
345, 939
224,634
107, 454
30, 003

126
304
467
364
331
198
49

40.9
100.8
91.4
105.2
147.4
184.3
163.3

8,067
7, 368
11,619
9,963
7, 866
4,086
2,208

,9
20
38
80
61
33
6

111.6
271.4
327.1
803.0
775.5
807.6
271.7

Total..................... 1,447,575
Standardized rates 1

1,916

132.4
150.0

1,828,206

1,839

100.6
111.0

51,177

247

482.6
596.0

15 to 19 years.............
20 to 24 years.............
25to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 years.............
65 years and over___

i Standardization based on the age distribution of the granite cutters of Barre, V t., 1911-1917.




106

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

78.—M O R T A L IT Y FROM A L L CAUSES, P U LM O N AR Y TUBERCULOSIS, AN D NONTU BER CU LO U S R E S P IR A T O R Y DISEASES, AM ONG T H E G R AN ITE CUTTERS OF
B A R R E . V T ., COM PARED W I T H T H A T OF SPECIFIED OCCUPATIONS IN TH E M ANU­
FACTURING AN D M ECHANICAL INDU STR IES OF EN G LA N D A N D W A L E S , B Y A G E
GROUPS—Continued.

T a b le

P U L M O N A R Y TU B ER C U L O SIS—Concluded.
File makers— England and Wales.

Cutlers and scissors mak­
ers—England and Wales.
1900-1902

Age at death.

15 to 19 years.............
20 to 24 years.............
25 to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 years.............
65 years and over___

5,466
4,941
10,818
8,952
7,233
4, 764
1,944

Total....................
Standardized rates1.

44,118

1890-1892

1900-1902

202.4
10
379.0
41
80
893.6
80 1,106. 0
734.7
35
154.3
3

3,597
2, 757
5,049
4,632
3, 345
1,596
699

1
6
22
38
27
11
3

27.8
217.6
435.7
820.4
807.2
689.2
429.2

2, 676
2,253
4,116
3,765
3,150
1,845
693

1
4
16
22
24

564.4
695.8

21,675

108

498.3
622.8

18,498

75

249

37.4
177.5
388.7
584.3
761.9
433.6

8

405.4
508.2

All occupied males—England and Wales.
Age at death.
1890-1892

1900-1902

4,185, 732
3, 668,295
6,147, 030
4, 714,230
3,426, 093
2,072, 076
1,178, 679

2,916
7,137
16,137
16,154
11,595
5,498
1,766

69.7
194.6
262.5
342.7
338.4
265.3
149.8

4,526,391
4.336, 335
7.337, 565
5, 668, 233
4,024,' 074
2, 424, 456
1, 202, 520

2,465
6,730
14,913
15,550
12,235
5,241
1,329

54.5
155.2
203.2
274.3
304.0
216.2
110.5

Total....................................................................... 25,392,135
Standardized rates1 ...................................................

61,203

241.0 29,519,574
295.9

58,463

198.0
241.5

15 to 19 years................................................................
20 to 24 years................................................................
25 to 34 years................................................................
35 to 44 years................................................................
45 to 54 years................................................................
55 to 64 years................................................................
65 years and over.........................................................

NON TU BER CULOU S R E S P IR A T O R Y DISEASES, B Y AGE GROUPS.

Age at death.

Stone and slate qnarriers-—England
Wales.

Granite cutters of Barre,
Vt.
1911-1917

15 to 19 years.............
20 to 24 years.............
25 to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 years.............
65 years and over-----

302
1,015
3,573
4,438
2,484
454
64

Total....................
Standardized rates *■

12,330

2
56.0
225.3
10
442. 8
11
9 1,982. 4
2 3,125. 0
34

275. 8
275.8

1890-1892
18,329
18,414
37,287
33,120
24,045
33,185
5,475

24,282
30,906
52,494
43,467
33,705
19,206
7,683

3
22
39
88
143
160
158

12.4
71.2
74.3
202.4
424.3
833.1
2,056.5

524. 8
362.5

211,743

613

289.5
227.6

Tin miners—England and Wales.

15 to 19 years.............
20 to 24 years.............
25 to 34 years.............
35 to 44 years.............
45 to 54 years.............
55 to 64 vears.............
65 years'and over-----

7,092
4,836
5,829
3,492
3,042
2,088
786

Total....................
Standardized rates ^- -

27,165

28.2
2
41.4
2
51.5
3
315.0
11
953.3
29
47 2,250. 9
45 5,725. 2
139

Lead miners—England and
1890-1892

1900-1902

1890-1892

511.7
434.4

4,032
2,895
4,548
3,462
2,142
1,344
549
18,972

1900-1902

7
42. 9
10
54. 3
51
136. 8
93
280. 8
155
644.6
227 1,721.6
233 4,255. 7
776

147,855

1
2
16
37
26
35
39

24.8
69.1
351. 8
1,068.7
1,213.8
2,604. 2
7,103. 8

1,989
2,325
3,705
3,336
2,718
2,028
726

1
1
3
8
16
46
52

50.3
43.1
81.0
239.8
588.7
2,268.2
7,162.5

156

822.3
864.4

16,827

127

754.7
356.6

1

i Standardization based on the age distribution of the granite cutters of Barre, Vt., 1911-1917.




and

107

COMPARATIVE OCCUPATIONAL MORTALITY DATA.

7 8 . — M O R T A L IT Y FROM A L L CAUSES, PU L M O N A R Y TUBERCULOSIS, AND NON­
TUBERCULOUS R E SP IR A T O R Y DISEASES, AMONG T H E G R AN IT E CUTTERS OF
BAR R E , V T ., COMPARED W IT H T H A T OF SPECIFIED OCCUPATIONS IN T H E M ANU­
FACTURING AN D M ECHANICAL IN DUSTR IES OF EN G LAN D AN D W A L E S , B Y AG E
GROUP S—Cone luded.

T able

NONTTJBERCULOTTS R E S P IR A T O R Y DISEASES, B Y AGE GROUPS—Concluded.

Lead miners—England

Ironstone miners— England and Wales.

Age at death.
1900-1902

15 to 19 years.............
20 to 24 years.............
25 to 34 years.............
35 to 44 vears.............
45 to 54 years.............
55 to 64 years.............
65 years and over___

1,302
1,662
3,243
2,478
2,295
1,383
621

Total....................
Standardized ratesx. .

12,984

1

•

1890-1892

2
61.7
7
282. 5
8
348. 6
21 1, 518. 4
33 5,314. 0

76.8

6,732
7,674
13,791
12, 216
8,385
3,696
975

72

53,469

554. 5
269.6

1900-1902

1
14. 8
65. 2
n
79. 8
18
147. 3
40
477. 0
44 1,190. 5
50 5,128. 2
169

316.1
245.0

Coal miners— England and Wales.
1890-1892
15 to 19 vears.............
20 to 24 vears.............
25 to 34 years.............
35 to 44 vears.............
45 to 54 years.............
55 to 64 years.............
65 years and over___

283,536
249, 525
380, 355
265, 098
162,981
80, 403
25, 677

Total................... 1,447,575
Standardized rates1

4,692

324.1
310 0

Cutlers and scissors mak­
ers—England and Wales.
1900-1902

15 to 19 years.............
20 to 24 vears.............
25 to 34 years_____
35 to 44 vears...........
45 to 54 years...........
55 t o 64 years... .
65 years and over___

5,466
4, 941
10 818
8,952
7,233
4,764
1,944

Total.................
Standardized rates1

44,118

1
18.3
1
20. 2
19
175. 6
20
223. 4
46
636. 0
55 1,154. 5
54 2,777. 8
196

444. 3
315.1

307,785
301, 512
510, 879
345, 939
224,634
107, 454
30, 003
1,828,206

1
1
9
10
31
24
23

20.5
14.3
68.7
96.0
361.2
497.2
1,527.2

50,295

99

196.8
155.1

Cutlers and scissors mak­
ers—England and Wales.
1890-1892

1900-1902

89
31.4
159
63.7
348
91.5
559
210. 9
929
570.0
1,325 1,647.9
1,283 4,996.7

4,869
6,984
13,104
10,422
8,583
4,827
1,506

26. 0
80
119
39.5
335
65.6
130.4
451
739
329.0
1,092 1,016.2
1,171 3,902. 9

8,067
7,368
11,619
9, 963
7,866
4,086
2,208

3
10
17
48
102
115
100

37.2
135.7
146.3
481.8
1,296.7
2,814.5
4,529.0

3,987

51,177

395

771.8
617.5

218.1
193.8

File makers—England and Wales.
1890-1892
3,597
2,757
5,049
4,632
3,345
1,596
699
21,675

1900-1902

1
27.8
5
181. 4
9
178. 3
22
475.0
36 1.076. 2
31 1' 942. 4
31 4, 434. 9

2,676
2,253
4,116
3,765
3,150
1,845
693

2
3
9
10
16
25
18

74.7
133.2
218.7
265.6
507.9
1.355.0
2.597.0

622. 8
549.0

18,498

83

448 7
335.2

135

All occupied males—•England and Wales.
Age Hi uraui.
1890-1892
15 to 19 years................................................................
20 to 24 years................................................................
25 to 34 years................................................................
35 to 44 vears....... ........................................................
45 to 54 years........... ...................................................
55 to 64 years..............................................................
65 vears and over__________ _____ ____ ______

4,185,732
3,668,295
6,147,030
4,714, 230
3,426, 093
2,072. 076
1,178' 679

Total.......... ..........
25,392,135
Standardized rates1...................................................

1900-1902

1,069
25. 5
2,245
61. 2
6,975
113. 5
?l, 784
250. 0
514. 6
17, 630
21,393 1,032. 4
30, 543 2,591. 3
91,639

4, 526,391
4,336,335
7,337,565
5,668, 233
4,024, 074
2,424, 456
1,202, 520

1,097
2,078
5,696
9, 432
13,364
15, 850
21,365

24. 2
47.9
77.3
166. 4
332.1
653.8
1,776.7

360. 9 29,519,574
283.7

68,855

233.2
187.0

1 Standardization based on the age distribution of the granite cutters of Barre, Vt., 1911-1917.
6 1 9 2 8 ° — 2 2 — B u ll. 2 9 3 -------- 8




108

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

STONE-DUST CORRELATION DATA.®
It does not fall within the present discussion to consider in detail
the technical aspects of the dust problem. It is anticipated that the
forthcoming results of the investigation by the United States
Bureau of Mines will present for the first time a full statement of the
facts required for practical purposes. It has, however, been thought
necessary to consider briefly the nature of the dust problems as
illustrated by the analysis of different types of stones quarried or
manipulated for commercial purposes. Table 79 contains an analysis
of the principal stones for important stone centers of the United
States, differentiating granite, sandstone, slate, limestone, and
marble. In each case the source of the analysis is indicated in the
footnotes. The averages in the last column of the table were arrived
at by the simple process of addition and division, possibly suggesting
the importance of more minute methods of collective sampling,
although it would seem that for the present purpose this method
will meet every reasonable requirement. The averages show that
for the principal stone centers of the United States the proportion
of silica in granite is 72.96 per cent, in sandstone 85.42 per cent, in
slate 61.54 per cent, in limestone 1.22 per cent, and in marble 0.97
per cent. The deviation from the average is clearly indicated by the
details for stone samples of the different States, but suggests, how­
ever, no change in the conclusion that an excessive death rate in the
stone industry is primarily conditioned by the silica content of the
stone manipulated. Hence it would seem of the first importance
that in any future investigations into the problem of stone-workers’
mortality the character of the stone manipulated should be taken
into account, and this, of course, suggests the further conclusion
that it is of equal importauce that the precise occupations followed
be considered rather than the trade or industry as a whole.
a For additional observations on stone-dust correlation data see remarks on pp. 22 and 23 and Appendix
D on the mineralogy of the dust problem, as well as Appendix E, giving the analysis of granite-stone dust
made by the Bureau of Mines from dust samples collected at Barre, V t., and Aberdeen, Scotland. For
an exceedingly important discussion of limestone and tuberculosis see an article by that title in Rock
Products of Jan. 14,1922, by Nathan C. Rockwood. This discussion is one ofthe most promising indications
of an approach ofthe question from the strictly practical p oint o f view, in that the article includes numerous
letters from representatives ofthe stone industry throughout the country, some of whom are strongly of
the opinion that limestone dust actually inhibits tuberculous processes, while others are of the opinion that
“ limestone dust has a beneficial effect on pulmonary tuberculosis.”




T a b l e 7 9 . — TYPICAL

ANALYSES OF GRANITE, SANDSTONE, SLATE, LIMESTONE, AND MARBLE.
GRANITE.

Vermont.1

Massachusetts.2

Maine.3

New Hamp­
shire.2

Rhode Island.2

North Carolina.4

Georgia.5

Wiscon­
sin.6
Aver­
age.

Constituent.
Barre. Bethel. Quincy. Milford.

Total.....................................................

Per ct. Per ct. Per ct. Per ct. Per ct.
72.02
77.52
73.93
73.02
69.89
12.29
16. 78
14.43
16.22
15.08
4.66
5.85
4.73
1.21
3.60
.62
4.63
5. 41
4.29
3.42
.31
1.18
2.56
.94
2.07
1.55
1.46
.84
.89
2. 59
1.04
2.91
1. 2o
77
.04
.66
.32
(7)
.21
.54
.59
.33
.68
99.76

100.18

100.91

101. 71

100.00

North
Jay.

Con­
cord.

Per ct.
71.54
14. 24
3.39
4.73
.98
1.18
.74
.34
1.45

Per ct.
74.47
14.15
1. 97
4.14
l .?0

98. 59

100. 21

1.21

1.16
.63
.78

RedWest"
stone ! eriy
stone* (gray).
Per ct.
71.44
14. 72
7. 66
.89

Per ct. Per ct.
70. 70
73.05
16. 50
14. 53
4. 56
1.72
2. 45
5.39
2.96
2.06
r
2.96 \ 2.34
.29
.09
.29

.46
2.39 }
.96
1.39
99. 91

Per ct.
71.64
15.66
1.58
5.60
2.70
2.34
.48
100.00

Mount
Airy.

......

100.00

99.89

Salis­
bury.

Elberton.

Stone
Moun­
tain.

Wau­
sau.

Per ct. Per ct. Per ct. Per ct. Per ct.
72.96
72. 56
76. 54
75.14
71.00
15.04
13. 82
14. 81
16.10
16. 33
4.05
4. 32
4. 94
5. 82
4. 80
3.76
2.31
2.57
5.30
4.65
1.48
.85
1.19
.93
1.83
.78
1.19
i. 62
.94
1.12
.26
.01
.35
.20
.04
.57
.20
.70
.87
100.60

100.95

100.64

99.67

100.09

1 The Granites of Vermont, by T. Nelson Dale, TJ*S. Geological Survey, Bui. 404, pp. 51-111.
* The Chief Commercial Granites of Massachusetts, New Hampshire, and Rhode Island, by T. Nelson Dale, U. S. Geological Survey, Bui. 354, pp. 81-193.
3 Twentieth Annual Report, TT. S. Geological Survey, 1898-99, Part VI, pp. 392,393.

4 North Carolina Geological Survey, Bui. 2,1916, pp. 106-155.
6 Granites of the Southeastern Atlantic States, by Thomas Leonard Watson, U. S. Geological Survey, Bui. 426, pp. 225-235.

* Building; and Ornamental Stones, by Ernest Robertson Buckley, Ph. D., Wisconsin Geological and Natural History Survey, Bui. No. 4, Economic Series, No. 2,1898, p. 136.
i Trace.

109




STOHE-DUST CORRELATION DATA.

Silica (Si02) ...............................................
Alumina (A I2 O 3 )..................................................
Soda (NaaO )...............................................
Potash (KgO)..'.........................................
Lime (CaO)................................................
Iron oxide (FeO).......................................
Iron segqmoxide (Fe20 s).........................
Magnesium oxide (MgO).........................
Other elements..........................................

Blue
Hill.

West­
erly
(red).

7 9 .—TYPICAL ANALYSES OF GRANITE, SANDSTONE, SLATE, LIMESTONE, AND M ARBLE—Continued.

110

T a b le

SANDSTONE.

Constituent.

Mary­
Minne­ Connec­ Massa­
New
chu­
ticut.8
Jersey.8 land.8
sota.8
setts.8

Ore­
Cali­
fornia.8 gon.*

Ari­
zona.8

Utah.8

Flagsta'T.

Jenn­
ings Colusa.
Spur.

Per ct.
79.1J
1.30

Per ct.
83.64
.46

Aver­
age.

Per ct. Per ct.
90.34
82.34
11.46
4.35
3.76
.19
1.30
.17
.27
.95
.74
1.09
.19
.17
.61
.87

Per ct.
93.13
3.86

Per ct.
85.60
7.25

Per ct.
98.69
1.06
.17

100.13

99.74

Per ct. P erct.
87.02
89. 33
7.17
6.05
.22
.59
2.12
1.43
.11
(7)

.19
.54

(7)

.11

.25
1.43

2.60
(7)
2.45

3.91
.06

1.41
(7)

99.51

97.90

99.92

99.50

.42
(7)

Per ct. Per ct.
70.84
81.38
9.44
13.15
5.43
3.30
3.09 ....... *76'

Frostburg.

Per ct, Per ct.
82.05
99. 25
.61
5.27

Per ct.
85. 99
4.82

.20

.60
3.35

.ii

7. 76

.25

.01

2. 48
(7)
1.71

3.54
.28
4.60

2. 71
.76
5.11

100.35

100.00

100.00

100.00

100. 22

1.96
2.45
.23
9.03

.70
13. 34

4. 49
.76
3. 94

99.96

100.10

100.00

Chit­
wood.

Per ct. Per ct.
72. 45
85.42
12.60
5.92
.70
.59
1.41
4.10
.23
10.80
2.44
.23
(7)
2. 8’7
99.95

99.81

8 Twentieth Annual Report, IT. S. Geological Survey, 1898-99, Part VI, pp. 356-445.
9 Building Stones of Ohio, by J. A. Bownocker? Geological Survey of Ohio, f ourth series, Bui. 18,1915, pp. 74-133.
10 Building and Ornamental Stones of Wisconsin, by Ernest Robertson Buckley, Ph. D., Wisconsin Geological and Natural History Survey, Bui. No. 4, Economic Series No. 2,

1898, pp. 175-197.

INDUSTRY,




GRANITE-STONE

Sand­
stone.

THE

Port
McDer­ Bass
mott. Island. Wing.

IN

Berea.

New­
ton.

East
Crom­
Avon­
Long
well. Meadow. dale.

PHTHISIS

Total....................................................

Wisconsin.10

1

Hummelstown.

Silica rSi02)................................................
Alumina (A I2 O 3 ).................................................
Soda (Na2 0 ) ..............................................
Potash (K 20 ) ............................................
Lime (CaO)................................................
Iron oxide (FeO).......................................
Iron sesquioxide (Fe20 3)....... ................
Magnesium oxide (MgO).........................
Other elements..........................................

Ohio.9

DUST

Pennsylvania.8

SLATE.

Maine.11
Constituent.
Monson.

South
Poultney.

Brow­ Hamp­
ton.
nell.

Gran­
ville.

Per ct.
62. 37
15.43
1.14
4.20
.77
5.34
1.34
3.14
6.07

Per ct.
59.84
15.02
1.12
4.48
2.20
4.73
1.23
3.41
8.25

Per ct. Per ct.
67.61
67.55
12.59
13.20
.67
.61
4. 45
4.13
.26
.11
1.24
1.20
5.61
5. 36
3.20
3. 27
4. 76
4.20

99.80

100.28

100.00

West
Pawlet.

Per ct. Per c t
54. 24
67. 76
24. 71
14.12
1. 43
1.39
.72
3.52
5.23
.63
4.71
8.39
.81
2.59
2.38
2.69
4.75
100.00

100.07

100.02

Pennsylvania.

Ham­
burg.

Ark­
Vir­
Cali­
Tenn­
ginia.11 essee.12 ansas.12 fornia.12

Lehigh ArvoDelta.11County12 nia.

Per ct. Per ct.
55. 88
67. 70
21.85
13.49
.46
4.91
3.64
.16
.81
9.03
2.75
1.29
9.05

1.50
7.10

100.00

99.62

99.91

Dan­
ville.

Per ct. Per ct.
47.30
66.16
15. 53
8.62
.64 } 3.17
4.96
7.83
1.77
3.44 } 8.00
9.04
7.86
.78
10. 04
2.47

Per ct.
63.39
15.97
/ 3.33
\ 3.60
.67

Per ct.
67.85
9.10
1.80
.44
.98
11.14

{ " 4 .’ 68*
2.99
3.65

3.23
5. 34

Per ct.
61.54.
15. 58
1.67
3. 08
1.96
3.34
3. 71
2.76
6.13

99.73

98.28

99.88

99.77

99.94

97.88

11Twentieth Annual Report, U. S. Geological Survey, 1898-99, Part VI (continued), pp. 394-458.
1SSlate Deposits and Slate Industry of the United States, by T. Nelson Dale, U. S. Geological Survey, Bui. No. 275, 1906, pp. 36-88.
13 Report on the Building and Ornamental Stones of Canada, by Wm. A. Parks, B. A,,. Ph. D .f Department of Mines, Canada, vol. 3,1914, pp. 238-242.

DATA.

Ill




Aver­
age.

New
Mont­
Mary­ gomery SlatRock­
ville. County. ington. land.

Per zt. Per ct. Per ct.
56. 38
60. 65
58. 45
15. 27
16. 87
21.88
2.34
2.18
1.30
1.60
3.80
3.51
4.23
1. 91
1. 85
3.23
6.04
1.67
7. 79
2.84
.46
2.39
4.32
7.31
11.96
100.39

Quebec.13

COREELATION

Total.....................................................

New York.11

STONE-DUST

Silica (Si02)................................................
Alumina (A I2 O 3 )..................................................
Soda(Na20 ) ...............................................
Potash (K 20 ).............................................
Lime (CaO)................................................
Iron oxide (FeO).......................................
Iron sesquioxide (Fe20«).........................
Magnesium ox’de(MgO).........................
Other elements...........................................

Vermont.11

112

T a b le 7 9 .—

TYPICAL ANALYSES OF GRANITE, SANDSTONE, SLATE, LIMESTONE, AN D M ARBLE—Concluded.
LIMESTONE.14

Indiana.

Kentucky.

Illinois.

Marble
Piqua.
Cliff.

Dun­
dee.

Calcite.

Per ct. Per ct. Per ct. Per ct. Per ct. Per ct.
1.42
0.62
3.56
2. 00
2. 01
1.12
/
1.41
.36
| .39
1.70 | 2.00
,!6
.39 }
.44
I
-41
92.00
93. 00
98. 36
98.20
98.11
95.79
98.43
95.31
1.12
.92
.38
.39
3.00
.65
1.82
1.76
.01

Per ct.
1.43
.44

Per ct.
1.20

Per ct.
0.81
.41

Per ct.
0.34

Per ct.
1.40
.58

97.51
.24
.36

97.67
.81
.32

95.00
3.86

97. 85
1.26

91.03
6.86
.55

99.98

100.00

100.08

99* 45

100.42

99.61

Per ct.
0.86

100.05

100.00

100.00

100.00

99.08

100.00

99.99

Bellefonte.

Per ct. Per ct. Per ct.
1.22
0.18
0.79
.13
.46
.19
.12
.23
96.37
98.75 ‘ *98.'50’
.73
1.37
.37
.01
.15
.33
100.03

100.00

99.87

Constituent.

Proc­ North
tor. Adams,

Total.

Per ct.
0.63

.01
18. 37
.77

.11

Pet ct.

Gouverneur.
Per ct.
3.55

Per ct.
1.26

Per ct.
1.01

*0.69

1.64

.1 3
*08 r
[
.08
93.86
87.06
5.34
6.40
. 05
1.73

100.00

P et ct.

98.95

.65
.29
87. 47
7. 50
1. 48

.23
.63
88. 94
6. 85
1.78

.04
76.17
21.79

98.65

99. 44

99.64

Georgia.15

Annville.

Marblehill

P er ct.

Per ct„
0.61

1.07
.14
.23
95.10
3. 96

.22

Tate.
P er ct.

Colo­
Cali­
rado.15 fornia.15

97. 32
1.60
.26

99. 87

100. 05

Aver-

Marble
Beulah, Colton. Marble Tokeen, Nitinat.
Cove.
Bay.
P er ct.

Per ct.

Per ct.
3.61

Per ct.
0.01

92.90
4. 50
2. 60

95. 44
1. 45

99. 51
.94

96. 89
.42

100.00

100.00

100.46

100.35

0.62 ’ “ o.‘ 06
.25

98.96

British
Columbia.18

Alaska.17

8.15

Per ct.
2.64
I

.40

Per ct.
1.26

Per ct.
0.91
.27
f
-14
2.16
1
.13
85.00
92.73
11.32
4.86
.54
99. 74

>9.64

14 Mineral Resources of the United States, Part II, Nonmetals* 1911, pp. 658-697.

16 Twentieth Annual Report, U. S. Geological Survey, 1898-99, Part VI (continued), pp. 359-447.
16 The Quarry Materials of New York—Granite, Gneiss, Tr&f>, and Marble, by D. H. Newland, Sixty-ninth Annual Report, New York State Museum, 1915, vol. 2, pp. 186-193.
17 Marble Resources of Southeastern Alaska, by Ernest F. Burchard and Theodore Chapin, U. S. Geological Survey, Bui. 682, pp. 53-69.
w Report on the Building and Ornamental Stones of Canada, by Wm. A. Parks, B. A ., Ph. D., Department of Mines, Canada, Vol. V, 1917, pp. 149-161.




INDUSTEY,

IhSolilblS matter...............................
Silica (Si02) . . , ..................................
AlUihni (AI2O3)...........................................
Iron sesquioxide (Fe203)..................
Calcium carbonate (CaC03) ...........
Magnesium carbonate (MgCOs) - -.
Other elements..................................

Penn­
sylva­
nia.15

New York.ie

GBANITE-STONE

MARBLE.
Massa­
Ver­
chu­
mont.15 setts.1
5

THE

Rush
Tower.

Inor.

IN

Car­
thage.

Per ct.
0.63

Millstadt.

Aver­
age.

PHTHISIS

Total....................................................

Mem­
phis
Junc­
tion.

Penn­
sylva­
nia.

Ohio.

Village
LaSprings. garde.

Bed­
ford.

Silica (Si02)................................................
Alumina (AI2O3).......................................
Iron sesquioxide (Fe203) .........................
Calcium carbonate (CaCOs).....................
Magnesium carbonate (MgCOa)..............
Other elements..........................................

Bloom­
ing­
Alton.
ton.

Michigan.

DUST

Constituent.

Missouri.

Alabama.

GRAPHIC PRESENTATION OF RESULTS.

113

GRAPHIC PRESENTATION OF RESULTS OF INVESTIGATION.
The foregoing results are presented in graphic form in six charts as
follows: 1. Comparative proportionate distribution of granite cutters
of Barre, Vt., limestone cutters of Bedford, Ind., and Transvaal gold
miners, by years of employment (Chart 1); 2. Mortality from speci­
fied causes among granite cutters of New England, compared with
that of the adult males of Massachusetts (Chart 2); 3. Mortality of
granite cutters of Barre, Vt., and adult males of Massachusetts, by
divisional periods of life (Chart 3); 4. Mortality from tuberculosis
of the lungs among granite cutters, by geographical districts and
periods of years (Chart 4); 5. Correlation between the chemical compo­
sition of stone and the mortality from tuberculosis of the lungs among
in ite cutters, sandstone cutters, and limestone cutters (Chart 5); 6.
amily mortality from tuberculosis of the lungs of granite cutters
compared with that of farmers of Washington and Caledonia Counties,
Vt., 1893-1919 (Chart 6).

f




114

Ch ar t 1.

y e a rs o f Em ploym ent in P re se n t O ccupation

P ercen t

Com por&t/i e

P ro p o rtio n a te D is tr ib u tio n

DUST

_

50----

PHTHISIS

K ey
c f Oran/te &//77esto/?e 7Fd/?iiA*t/
&/?p/oymeot Putters
(?ic/terv &c/dSf//?ef&
A*>tfvrd, //?</ I/, Jo S/-r,
tXsrre,

I

BBS
I

50./O
40.04
Q,49
/./7
O./O
o.cfe

‘76/cf/

100.00

/oox>o

/oo&o

GBANITE-STONE

^0,96
/9<69
£5.64
/5,35
7.17
4.09
3jys
/t£9
/, 28
0.26

THE

30-

e,oo
A’,55
/P./O
A'<5,07
/5,7d
// .50
5 <06
5,35
/,49
0.7/
0,56
0,09

IN

I

I

W//M

/-4
5-9
10-/4
15-/9
SO 24
P5-P9
JO-54
55-59
40 44
**5-49
50 54
55 59

I

INDUSTRY,

y em cf 0 Employment




«na_

^

5 -9

3 5-3 9

4 0 -4 4

4 5 ‘ 49

—,— mm
50 -S 4

i,m— — ~ years

cf

55-5Q £m/)foijm e,7t

Suujtialn’s Department, The PnKkntul Injuranct^Ccimpany Oi /

Ch a r t 2 .

Sforf&fift/ from Specified Causes among Granite Cutters o f jVeu) Eng/and
Compared u)ith that o f the J*lale Population o f /Vassacbusefts
sides 20 fo 69, 61/ Periods o f //ears

Pdtes per too.ooo Sxposed
GRAPHIC

Tuberculosis o f the Lungs

ran/teCutters453JI
1900-/904/G
fdSs. /fd/es

PRESENTATION

Ordo/teCutters 6!1.6
I9Q
5-/909 /fess
/fd/es 2250\
m/teCutters 0022.
/9J0-/9/4 O
/fdSS.f/d/es 200.
rd/?/feCutters/OfO]
/9I5-19/Q«0
/f<m. /f^/es

P /jeu rrron /&

B ronchitis

{9/o - m

/9/5-19/d *

JO

(0.2

/fd<5S /fd/es

5rf/?/teCutters
ffdss /fd/es
t>rj7/teCutters
/fd-ss Jfd/es
Crd/?/feCutters
ffdss /fd/es

* Orsn/te Cotter# — iTxc/uMi/e g f /asf three mo/)t/>s c f /9/d
• Sfass /fates — W 5-/9/? on/tf
iL_______________________
-




i5

RESULTS.

/900-M f

QramfeCarters

OF

Aonfubercu/ous R espiratory Diseases

20/J6
M j6 I

Experience <$/ 7fte Oran/te Cu/ters' f/2ter/?dt/o/?df JZsdoc/dt/O/) qfrfmer/c*
S
ta
tis
tic
ia
nj D
e
p
a
r
tm
e
n
t, T
h
rP
r
u
d
e
n
tu
l In
s
u
r
a
n
c
eC
a
m
p
w
yof tanta

116

Ch art 3.

Morfalittt o f Orsnite Cutters ofBarre, Vermont, front Specified Causes oncf t?y jfpe

/joo

&<3te& per /OO, OOO Z?xpQ<3&cf
sooo

2300

aooo

j.soo

PHTHISIS

6mite Cutlets 356.2
J5-Z9 ffdss,
S/die* W £
6rsn/teCutterf3756
fbss. //dies 2/5.6
G/vn/'te Cutters!J
ffojs. tfoteS 2265
GraniteCutters3,873,6
ffyss./fdtes 2?2j
OrvniteCuttersS.?d&3
tfoss. JidJeS ]7Jt>

IN

50-59
60over'

fyvniteCutters H84J
3oyer Sfyss. Sfc/es
*372

7?dte<s per 700,000 Exposed

37.6!
I54j\

GKASTITE-STONE

W ^ MsS.Mtes

THE

AQ fifu& ercu/ous & espir& fow / D is e a s e s

J?<?e
6/snitv Cutters
Mss./fates
30 -3 QQw'te Cutters
M ss/fc/es
a/j.ao^mite Cutters
w
/Use./tote*
M.qo Onn/teCutters

MpJ

$Cd.7\
/5J.5
TVAd\

26X6

Mind GraniteCutters 3.4$82\
0 °*r JfdsS./ftfeS
* mS tovnikCutters 2?S6\

**r

t?S£'

jfff Causes

7?jfe$ per
/ 5-&
JO-39
40-*?9

50-59
60$?fr
#X r

i,OOQ Exposed

INDUSTRY,




DUST

Cornp& red u)ifh th a t o/ th e Ma/p P opu f& fion ofJ tf& ss& cfiu sG ffs, /9II-W J7
T u b ercu losis o f fir e £urtgps

sp
45

drun/te Cutter#
ffass. ffyfeg
Granite Cutters
Jfjss. Steles
Ordnite Coffers
ffdss. Mates
&rdn/ie Cutters
Afd&s. Sfd/as
Granite Cutters
ffdss. JfateS

7.6
2Z2
t2J
m
&f
tjsj
7m

&rdnite Cutter#
jfess. ffs/es

m
tw

?sS

Exper/ence c f Tffe Granite. (Puffers fnferr)<2t/on<t/ JZssoctjftor) qfo/faer/ias
Statistician's D eparting^ The Prudtntul Luunnce Company of America

C h a r t 4.

jy® rfa titu fro m Tu b e rcu lo sis o f th e b u n g s a m o n g G ra n ite C u tte rs
b y Geographic#/ D istricts and Periods o f f/ears
<Pt}fes p er 100,000 Exposed

Jteu? England States

S ' ««<

/90J

'w '™ -' I

/904m 6&J

: o m a raa

l/e<ir<s Pafe 0
/896~

% ,6 7 S .6

JV orthu)estem a n d —
©
^Qocfa/ /fount&rn S tates

© Centrat Jftfantic States
yeans 7?ate

@96-

/<*7

300 iop

Tfie United States

/9M- *071
/9 //

Comp&retf uXffr tfreS fd/e P oputerton,
zj7pes ? 0 end Ot?er, o f

/9/2- 7273

jo

/903

Massachusetts
P a cific C oast and —
<§)
(Stoiitfi& estern (States

✓/ <- fbte
«w
ye&ps

1696-/903
.%>*
Gram/eCutters 426,4\
ffos* AWes 26517

OUtt K9 090

© <
South J ftta n fic and &ou)er

J V ississippj ^\ feffed (States

years ferfe 0

W 4 -m
Gr<3/)/teeu/tens 557.9
/fa*t<jt ffd/es 22Z£.

r fd9SI

r"/£?.?■

19/2-/9/6 »

=

GraniteGutters 64ZJ
m s-m es

_

2006%
<iTorSfyssachusette. 1912-/9!?

$ Sxc/ustife of /as/- three months of/9/d




£xper/e/)ce of 7fe Grjnj/e

j s io iiy i .n::i s ® m

®

fejA f Ps/oQ

/fens' //?termt/on<f/ JZssac/df/o/i
i’i Department, The Pmdcrmal Insurance Gxp.nany of Amcnca

•snnsau

Upper ft/ssiss/pp/ ifo/fey
0
^ a n d G reatL akes S tates

118

Ch ar t 5.

Chemical Composition **
O ron /fe

S o’anndd ssto
fo n e
Percent,
65.42
532 ■
0.70
0.59
101
204 I
0.23

P ercen t
d ll/ca
(*J°*)
72.96
etfJumfna (^ O j)
15.04
<&oda
(^ O )
4.05
'Po/otJ/i
(*0>o)
3.76
4 me
(c*o)
m
/ron SeSqu/oxide(^ 2 0s) U 9
Iron Oxide
( ** ° ) 0.76
Calcium Carbonate (ctcoj) —
O tters
0.74\

is/ m esfo n e

Percent
1.22

0.46

9637
m

329 1

Sforfofifu from Tuberculosis o f tftc lungs
%>a/e per 100,000 2?xpo<&ed

G ra n ite C u tte rs
p ea rs
1905-1909

mo-im

L im eston e C u tters

S o n d sto n e C u tters

6Z6j8

6/Z.6

60Z?

3 6 2 6,
4Z5.5

1915-1916* 1.044.3
Jfok:

C
l^cOccupational'Jfarfa//fy.
?arefromMe3£kper/enees<f
Tfte/nfe/v7&f/ona/ 6mn/te

9fieGlassJkfffe&ootensy&sxAjfyb/?
gfffle Cfo/M<5tatBSandGjixtda.




C om p a ra tive M o r ta lity R a te s
G lass Bott/e B fouters
S la ss& cfju seffs Sfefes
<^/7aeS A5 and OiSe/-

{/ear<£
1 9 0 5 -1 9 0 9

3 6 /J

1 9 1 0 -1 9 1 4

3 ? 3 jO \

1 9 1 5 -1 9 1 6 *

m

lim e s to n e C
1 9 0 5 -1 9 0 9 /? c lu d e M a n y W /io
W ere O r/g /h a f/t/’ d ia n d ffv n e
G u te r s . °Z ^Z ^ 'P o s s jb /y '
&afe Di/rmp Tfteseyears.

9 \

♦ * <*fcsvposrfe JZiterayeS £er/i?edfrom

Jfote

Accepted Sources

t /fe '56. Sfa/es, M5-1917
Sunsocun’t Dtparancm , The Prudential Insurance Company of AmctWft

DUST PHTHISIS IN THE GRANITE-STONE INDUSTRY,

C orrela tion b etw een Cfiem ic&f Com position o f S to n e
and M ortality from Tuberculosis o f the Lungs among Stone C u tters

Ch a b t 6.

^Fh/nlfu M orfa / Ifu fr o m T u b ercu / o sis o f f i f e L u n g s ; 7wmi/ies o f Granite Carters
Com d o re d u^M fftose o f fa rm ers, o f tfasfi/ngfon and C&fedon/o C ou n ties, Verm ont, /S93 -Z9/9
'Percent of' D eaths from MU Causes

t f /f e

D aughter

S I o th e r

‘f a th e r

S on

/&?I l
&0§L|
'r& w tB
fidjA

• « 1" "

~|

B ro th e r
' ™

—I

*/J |

wed

Subsequent Deaths o f Qelatii)es due to Tuberculosis o f the &umrs

Jrom

Daughter

Wfj&
Qt/ierGiu$$$ 3.6M
I

~1

S/other
"I

at^gp—

^^pHH

OtterGiuses
'Farmer#
Who

died

B rother

Tuberculosis o f the /^unos

M other'

i7faf‘h er

^ 'M K I

Son

B roth er

w jB M

—I

Subsequent Deaths o f Qefatitfes due to Tuberculosis o f the £>unos

Jrom

Wife
° -'p

Daughter
/ o o o p K N H K B tK A ,0^ jk

Sfother

Toother
jH

Son

RESULTS.

Daughter

Son
///p

P rio r Deaths o f Qelatii)es due to
Wife

"father

OF

B rother
/^ | B

Sucuooin's Department, The PrudenciaJ Iniunncc Company of Amend

119




Cutters

PRESENTATION

Gran/fa

GRAPHIC

Prior Deaths c f Pelafii>es due to Tuberculosis o f the tuners

DUST PJEETHZSXS IN THE GRANITE-STONE INDUSTRY.

OTHER INVESTIGATIONS.
GERMAN OCCUPATIONAL EXPERIENCE.

It has not seemed necessary to amplify the foregoing statistical
observations by an extended discussion of other inquiries into the
mortality of stoneworkers. The subject is dealt with in some detail
in Mortality from Respiratory Diseases in Dusty Trades (Inorganic
Dusts), published by the United States Bureau of Labor Statistics in
June, 1918 (Bulletin No. 231). Reference, however, should be made to
two important German investigations of 1913 and 1915, although they
are useful as an indication of the method to be followed rather than as
finally conclusive ^concerning the results. These writers have clearly
realized the importance of considering the chemical and mechanical
aspects of the dust problem, following in this respect the admirable
discussion of dust and occupation in Grotjahn and Kaup’s Hand­
book of Social Hygiene.4 American textbooks on occupational dis­
eases fail in not giving equally extended consideration to this impor­
tant aspect of the occupational disease problem.
The first of the two special investigations referred to is a treatise
on the stone industry in the Grand Duchy of Baden by Dr. Fohlisch,
originally contributed to the annual report of the Grand Ducal Fac­
tory Inspection Service of Baden for the year 1912.5 In this dis­
cussion the author, following a brief geological outline, takes into
account the technical aspects of the stone industry, its statutory
regulations and control, the economic and social condition of labor,
hours, wages, labor laws, labor organizations, safety regulations, and
sanitation. Attention is given to the experience of local sick funds,
but limited, unfortunately, to the years 1910 and 1911. The sick­
ness figures throughout are higher fox stonecutters than for quarrymen or other stoneworkers. For sandstone workers the morbidity
from pulmonary tuberculosis was 3.7 per cent for stonecutters, 2.2 per
cent for quarrymen, and 0.3 per cent for other employments. These
statistics are for the sick fund of Freudenberg and probably typical
of the industry. The analysis, unfortunately, is too limited to be as
useful as the intrinsic value of the data would suggest.
For granite workers the sick fund of Achern returns a morbidity
figure of 6.6 per cent for all occupations, against 3.7 per cent for
stonecutters in the sandstone industry. Dr. Fohlisch, however,
states that the mortality data do not seem to indicate an excessive
death rate from tuberculosis, but the conclusions are based on entirely
too fragmentary a statistical basis to accept them as final. He ex­
plains, however, that the observed result in all probability is in part
attributable to the comparatively recent introduction of the industry,
in that several generations would be required to establish the true
incidence of the disease as the result of occupational conditions.
This, of course, is in strict conformity to the conclusion elsewhere
advanced— that it requires on an average about 21 years of occu­
pational exposure to show the most disastrous effects of considerable
and continuous granite-dust inhalation.
The second discussion, of present importance, is by Dr. Franz
Koelsch, who, in 1915, contributed a discussion on the lung diseases
4Handworterbuch der Sozialen Hygiene, herausgegeben von Dr. med. A. Grotjahn und Prof. Dr. med.
J. Kaup; Band II, Leipzig, 1912.
5 Die Steiiiindustrie in Grossherzogtum Baden, von Regierungsrat Dr. Fohlisch, Beilage zum Jahresbericht des Grosh. Gewerbeaufsichtsamts fur das Jahr 1912, Karlsruhe, 1913.




OTHER INVESTIGATIONS.

121

of stoneworkers to the Central Organ for Industrial Hygiene,6 in
continuation of an earlier and even more extended discussion con­
tributed to Grotjahn and Kaup’s Handbook of Social Hygiene (Vol.
II, pp. 512-530). Dr. Keelson is one of the foremost authorities of
the present period on industrial diseases, with particular reference to
original investigations into the conditions under which industry is
carried on. In the discussion referred to the excessive mortality of
stoneworkers from pulmonary tuberculosis is emphasized, although
the statistical data are far from sufficient for entirely safe conclusions.
There are extended observations on the pathology of dust inhalation
and much new information, which seems not to have attracted the
attention it should have, probably because the paper does not appear
to have been translated in its entirety. It is pointed out, for illus­
tration, that in the administration division of Marktheidenfeld,
where special investigations were made, during the period 1899 to
1908, 17.3 per cent of the total mortality was from tuberculosis,
while for particular stonecutting localities the rates per 1,000
exposed to risk were as high as 8.5, 6.2, 5.8, 4.4, 4.2, and 3.7, against
a general average of only 3.1. These results conform to the observed
experience in the State of Vermont and suggest that where the local
death rate from pulmonary tuberculosis in industrial districts exceeds
the observed average, it is a safe assumption that the causative factors
for the excess are industrial rather than general. Dr. Koelsch draws
attention to another fact, also observed in the granite centers of
Vermont, that increasing difficulty is experienced in securing appren­
tices for the stonecutting industry, largely as the result of the known
excess of tuberculosis in the stoneworking trade. The method
adopted by Dr. Koelsch would have been more useful and conclusive
if the statistical data had been more representative of the industry,
both as regards the number of wage earners exposed to risk and the
period of time over which the observations extended. ^See Appendix
H, p. 162).
RECENT BENDIGO (AUSTRALIA) INVESTIGATION.

There has recently been published an extremely interesting and
practically useful report on an inquiry into the prevalence of tuber­
culosis at Bendigo by Dr. D. G. Robertson, of the Quarantine Service
of the Commonwealth of Australia. This publication is certain to
become a classic in occupational-disease investigation, partly on
account of the method of inquiry developed and partly because of
the extraordinary results disclosed. It is an admirable and brief
presentation of a subject of enormous importance to the mining
industry of Australia, the results of the investigation being sum­
marized as follows:
1. The necessity for some scheme of compensation for miners with advanced damage
to their lungs caused by their occupation.
2. Accommodation for early cases of tuberculosis.
3. Accommodation for advanced cases which are at present acting as centers of
infection.
4. Early action to insure complete cleansing and disinfection of premises now
occupied by advanced cases of tuberculosis.
5. Definite continuance of supervision of contacts who have reacted to the tuber­
culin test and shown indications of having been infected by tuberculosis.
6 fiber die Lutigenerkrankungen der Steinhaoer, von Beginnings imd Medizinal-rat Dr. Franz Koelsch,
in ZentralbLattfur Crewerbehygiene, Vol. I ll, pp. 259-264, 273-279, Berlin, 1915.




122

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

The report includes appendixes and cards used in the Bendigo
campaign, a report form, and a poster calling public attention to the
tuberculosis facts, particularly to miner’s phthisis or fibrosis. It is
only possible on this occasion to make mention of the extraordinary
increase in frequency of pulmonary diseases among the miners in
the Bendigo district from a rate as low as 78.42 in 1908 to a rate
as high as 163.79 in 1918. Deaths from pneumonia have likewise
she" + a tendency to increase. The statistical investigation is
summarized as follows:
1. Tuberculosis, particularly pulmonary, has been markedly more prevalent in
Bendigo than elsewhere in the State of Victoria.
2. The section of the population most greatly affected has been that of the adult
males. There has been a progressive tendency for the clinical manifestations of
tuberculosis to be exhibited amongst males as age advances, reaching a maximum
about the sixtieth year.
3. There has been an increased incidence of tuberculosis among females, com­
pared with the rest of Victoria. Females of all ages showed an increase of 25 per
cent, and those over 18 one of 18 per cent, during the last 14 years over the rate of
the female population of Victoria as a whole.
4. The rate of tubercular disease other than pulmonary showed only a slight
increase compared with that of the State as a whole.
5. The presence of miners in the community and their occupation has undoubtedly
been an important factor in the production of the high rate of disease in Bendigo.
6. There has been a steady diminution in the incidence of tuberculosis in Bendigo
during the last 30 years, Bendigo sharing this fall in common with the State of Victoria
as a whole.

The general conclusions of what will always rank as one of the
most lucid contributions to the problem of dust phthisis are as
follows:
1. It has been proved in the statistical portion of this report that the incidence of
tuberculosis has for many years been very much greater in Bendigo than elsewhere
in the State of Victoria.
2. One hundred and fifty-one cases of tuberculosis were living in the Bendigo
district at the end of July, 1920.
3. No measures whatsoever are being taken by the local health authorities to
prevent advanced cases of consumption from spreading the disease. No hospital
accommodation for this type of case is available, and patients have therefore to
remain in their own homes. No supervision is exercised, and the health authorities
are even unaware whether the notified cases are living or dead, residing in the resi­
dence stated on the notification or not. In other words, notification is practically a
waste of public money.
4. Medical practitioners are mostly reporting pulmonary tuberculosis when very
advanced; 86 per cent of the deaths during the last five years from this cause have been
notified within six months of death. Moreover, cases proved definitely tubercular
by the findings of tubercle bacilli in the sputum and dying during the period of the
investigation have been signed up on the death certificates as “ fibrosis of the lungs.”
These facts emphasize the necessity for better facilities being given the medical pro­
fession for more thorough examination of their patients. A laboratory for the investi­
gation of clinical material and the services of a competent radiographer at the Bendigo
Hospital are absolutely essential.
5. Strong presumptive evidence of the infectious nature of tuberculosis has been
obtained through this investigation. Practically one-half of the cases investigated
gave definite history of exposure to infection. More striking is the fact that 65 per
cent of the home contacts of advanced cases of pulmonary tuberculosis gave positive
Von Pirquets, as opposed to 21 per cent where no history of exposure to infection was
obtained. Seventy-eight children under the age of 15 gave definitely positive Von
Pirquet reactions, and in only two of these was there no history of exposure to
infection.
6. It is considered that the incidence of tuberculosis in the Bendigo district demands
immediate measures being taken to combat its spread, and if possible to eradicate it.
The measures considered most suitable are as follows:
(a)
The erection and equipment of a sanatorium. Accommodation for at least 100
persons should be provided. This sanatorium should be divided into two sections,




OTHER INVESTIGATIONS.

123

one for advanced and the other for early cases. To this sanatorium all advanced
cases should be encouraged to go. Where the home conditions of a patient are such
that infection to others is most probable, then the compulsory clauses of the health
act should be enforced.
(6)
The old supreme court building should be maintained as a clinic. Here all
consultations of tuberculosis patients may be made, a dispensary for the treatment of
home patients established, and the laboratory used for the investigation of clinical
material.
The staff required immediately would be one medical officer and one nurse. Pend­
ing the building of the sanatorium their time would be fully occupied in keeping the
patients and those giving positive Yon Pirquet reactions, mentioned in this report,
under surveillance, whilst their medical treatment may also be undertaken, rtfc
would also be advisable to subsidize the Bendigo Hospital, so that the services oi a,
competent radiographer might be obtained. Arrangements should be made for the
local health authorities, or, failing them, the central authority, to advise the medical
officer of all notifications as soon as received.
7. Better financial assistance should be rendered to families where the breadwinners
are incapacitated through tuberculosis. In many cases it is difficult to prevail upon
sufferers in the early stages to undergo sanatorium treatment, as it means their families
are practically left to starve. The invalid pension should continue in all cases where
the pensioner undergoes hospital treatment for tuberculosis.
8. A miners’ compensation act should at once be introduced. It is pitiful to note
the great distress prevailing at the present time throughout the Bendigo district by
reason of a large number of the wage earners being totally incapacitated solely through
their occupation without any monetary compensation beyond the State grant of five
shillings per week. The compensation afforded should extend to the widow in all
cases. As emphasized previously, a large percentage of miners die from tuberculosis,
and their children show evidence of infection, and therefore require careful attention,
which is impossible under the present financial circumstances of most of the families.
AMERICAN INDUSTRIAL DUST INVESTIGATIONS.

Winslow and Greenburg in an article on “ Industrial tuberculosis
and the control of the factory dust problem,” in the Journal of
Industrial Hygiene for January, 1921 (pp. 333-343), and February,
1921 (pp. 378-395), summarize most of the available information on
tuberculosis and dust control, emphasizing in a general way the
specific influence of particular dusts in relation to tuberculosis,
without, however, clearly differentiating the important conclusion
that the prevailing types of industrial lung disease are in all prob­
ability more of the nontuberculous than of the true tuberculous
variety. Thus, for illustration, the conclusion that “ it is clear that
the dusts to which workers are exposed in metal mining, quarrying,
and grinding strongly predispose to tuberculosis and that the dusts
produced in coal mining and cement working do not,” fails to draw
attention to the fact that in the light of more recent investigations
it is safe to assume that the prevailing disease types are nontubercu­
lous, certainly so in their origins, rather than of the true bacillary
tuberculous variety of lung disease. The authors of this important
contribution, however, advance the solution of the problem materially
by their technical discussion of the factory-dust problem, including
a summary of the determination of the average dust content of the
air in various types of industrial establishments, which should be
useful for practical purposes in further investigations into the nature
of the dust problem in the granite-cutting industry. The discussion
includes observations on the control of the dust hazard by the wearing
of respirators and helmets and on the importance of different analyti­
cal standards in the control of industrial dust hazards, concluding
with the statement that “ a standard based on the number of one61928°— 22— Bull. 293------ 9




124

DUST PH TH ISIS IN TH E ORANITE-STONE INDUSTRY.

fourth standard unit (1-10 microns) particles in the air should prove
even more valuable than one based on weight,” and that “ so far as
the number of small dust particles is concerned, there is no great
difference between well-equipped grinding and polishing shops. In
either case [the] studies [made] indicate that the dust content of the
air can be kept generally under 300,000 one-fourth standard unit
particles per cubic foot and should not average over 200,000 such
particles.
It is said, however, that these standards are only tenta­
tive and that they are subject to revision “ with the development of
a wider knowledge of the air conditions in representative workshops.”
The articles include a useful bibliography of recent contributions to
the dust problem.
SUGGESTIVE MEDICAL OBSERVATIONS.

In connection with the foregoing, attention should be directed to
a most important discussion on the relation of pulmonary tubercu­
losis to silicosis in Cobbett’s Treatise on the Causes of Tuberculosis
(Cambridge, 1917). This discussion from the medical point of view
is of the first importance, as it includes extended observations on the
nature of dangerous dusts, followed by remarks on the low degree of
infectiousness shown by that form of phthisis which is common
among persons whose work compels them to inhale the dust of hard
siliceous stones. This investigation by Cobbett is fully confirmed
by the new data for the granite industry of Vermont, which also
supports, among others, the conclusion “ that there appears to be no
ground for thinking that home infection or family susceptibility has
played any considerable part in the causation of the disease.” Cobbett
quotes Wheatley to the effect that “ many of the cases returned as
phthisis may have been nontuberculous lithosis.” He takes exception
to the conclusion advanced by Collis “ that tubercule bacilli after
growing in lungs which have been modified by silica dust become
less virulent.” In his opinion this seems very improbable, and he
advances a simple explanation, believing that “ there is a scarcity of
bacilli expectoration.
He also directs attention to the fact that
“ tubercule bacilli would seem to be remarkably scarce in the sputum
of South African gold miners who suffer from phthisis.” He quotes
Arlidge to the effect that “ in cases of potters7 consumption from
inhaled dust bacilli have been sought for in vain,” ana therefore
concludes that “ it is indeed by no means certain that the phthisis
which is so frequently a disease among the classes of workmen which
we are now considering is always a manifestation of tuberculosis.
In its early stages, at least, it is probably not so.” The work con­
tains much additional evidence to this effect and clearly sustains the
conclusion arrived at on the basis of the Barre data-—that the pre­
vailing type of industrial lung disease in granite-stone cutting is not,
in its initial stage at least, a bacillary form of pulmonary tuberculosis.
THE PROBLEM OF LtTNG FIBROSIS.

It is precisely this confusion of terms which seems to justify the
broader viewpoint which underlies the present investigation—that
what we are here concerned with is not a true form of pulmonary
tuberculosis in the accepted sense, but rather a lung fibrosis, possibly




OTHER INVESTIGATIONS.

125

in the majority of cases complicated by a terminal tuberculosis infec­
tion. Notwithstanding an extensive literature on the subject, this
aspect of industrial lung disease has not received the necessary amount
of qualified consideration. In an interesting and practically useful
contribution on “ Pulmonary fibrosis, tuberculous and nontubercu­
lous,” contributed to the London Lancet under date of June 1, 1918
(p. 765), Dr. G. T. Herbert, tuberculosis officer for Hackney and
Bethnel Green, takes occasion to say that “ in all except the acute
cases of pulmonary tuberculosis a greater or less degree of fibrosis of
the lungs occurs. So striking are the physical signs of fibrotic tuber­
culosis m an adult of over 40 [years of agej who has extensive dis­
ease but few symptoms apart from cough and dyspnoea, and so un­
common are cases of fibrosis due to other causes in this period, unless
accompanied by bronchiectasis, that the idea of pulmonary fibrosis
has become inseparably linked with that of chronic pulmonary tuber­
culosis. The physical signs due to the fibrosis are subconsciouslyregarded as due to the essential tuberculous lesions, with the result
that fibrosis found in children of school age is often diagnosed as
tuberculous without hesitation and without consideration of the
possibility of a cause other than tuberculosis.” What is true of chil­
dren is even more true of adults with continuous exposure to minute
articles of inorganic dust. Certainly as early as 1894 Sir Andrew
l&rk and others, in a discussion of fibroid diseases of the lung,
clearly differentiated three groups of pulmonary fibrosis as follows:
1. Pure fibroid or fibroid phthisis, by which is understood a condition
in which there are no tubercles; 2. Tuberculo-fibroid disease, a con­
dition which is primarily tubercular but subsequently runs a fibroid
course; 3. Fibro tubercular, a condition in which primarily fibroid
disease has become tubercular.
From a careful and extended consideration of the mortality exper­
ience of granite cutters the conclusion would therefore seem justified
that the disease generally diagnosed as pulmonary tuberculosis is in
truth fibroid phthisis, as thus defined by Sir Andrew Clark, and is
considered free from tubercular infection, while in the majority of
cases the disease is probably fibrotubercular or an original fibrosis
complicated by subsequent and true tubercular infection. Dr. Her­
bert adds his own explanation— that “ the first group [fibroid phthi­
sis] is convincingly proved to be a common disease, clinically and
pathologically, and would doubtless have been accepted and known
as such if a satisfactory name had been found for it. After rejecting
the termjs 1fibroid degeneration/ 1silicosis/ 1chronic pneumonia/
iinterstitial pneumonia/ cmelanosis/ and ‘ gray induration/ [Sir
Andrew Clark and his associates] chose ‘ fibroid phthisis/ to contrast
it with ‘pulmonary phthisis/ the name which they considered would
stand forever unchanged for what is now known as ‘ pulmonary
tuberculosis/ ”
The writer is not aware that this viewpoint is generally accepted
on the part of medical pracj^tipnprg* witjp.* e#£pejience among granite
cutters, and there is no tmfrgtec{adkSE^e it cM tji£ pa^t of the Vermont
State Medical Society X£t#it must be seTf^&vMentT,as regards
both diagnosis •
treatment a precise differentia^fdn.%^f: disease
types must b^of/the first importance, and the same conclusion, applies
to methods of'suQce^sful prev;enti<m^nd centred*.
\ ;

g




126

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.
DIAGNOSTIC DIFFICULTIES.

As regards the diagnosis of early phthisis, it must be kept in mind
that there are generally four accepted conditions: 1. Cough and
expectoration; 2. Loss of weight; 3. Loss of appetite; 4. Rise in
temperature.
The view is now generally accepted that no phthisis can exist
without these symptoms in the ordinary way; but how far these
symptoms are characteristic of fibroid pnthisis in its initial stage is
open to question. Dr. Herbert in the article referred to (p. 766)
remarks: “ Tuberculosis infection is almost ubiquitous, but resultant
tuberculosis disease of the alveolar tissue comparatively rare. Com­
monly in children, and probably frequently m adults, tuberculosis
disease has developed from an old tuberculous infection, and in
doing so has passed through four successive stages, namely: 1. That
of tuberculosis processes in the root glands, recognized by laboratory
tests; 2. That of changes in the walls of the air passages, said to be
(but not proved to be) tuberculosis by radiologists; 3. That of early
tuberculosis invasion of the lung tissue, which may give rise to
signs recognizable on examinations; 4. That of more or less advanced
disease, with tubercular bacilli in the sputum.”
He points out in this connection that the stages indicated “ over­
lap to a certain extent and in any given case the changes may
be active or inactive.” But it must be self-evident a diagnostic
principle applicable to pulmonary phthisis may be widely at vari­
ance in the earliest possible recognition of a case of fibroid phthisis.
Quoting once more from Dr. Herbert, “ the intermediate group of
fibro-tubercular disease is responsible for much of the confusion that
exists between the extreme types.’ ? But unfortunately he did not
consider the much more important type, from the industrial view­
point, of fibroid phthisis, which there are the strongest reasons for
believing is much more often erroneously diagnosed as a tuberculofibroid disease. If the present discussion fails, therefore, in con­
forming to the foregoing principles, it is because the prevailing lung
disease in the Barre granite-cutting districts is almost without
exception diagnosed as pulmonary phthisis, making it necessary
that for the present purpose the term “ industrial lung disease”
should be given the preference.
THE PROBLEM OF DUST INFECTION.

The infectious character of true pulmonary tuberculosis justifies
measures of prevention and control essentially different from those
made in efforts to reduce the excessive incidence of fibroid phthisis.
The dictum of Sir Douglas Powell, “ that if there were no dirty
surroundings and bad habits of life the infection of tuberculosis
would also cease to be operative” is still the accepted one. But in
fibroid phthisis it is not primarily a question of infection, but one of
lung injury as the resultfcpf,coiituiupus and considerable dust inhala­
tion. The lung disaXse.kffectifg-g/ariJfcB*cutters is not essentially
conditioned..^li.^ltKy‘ sHrrcrundlngs’ he? <0^ air. *organically contam­
inated,
a*’dust-laden atmosphere' rc^HWigrg* .from industrial
processes,* *Miich may or may not admit of effective/control. Sir
Malcoliir* Mgryis has# on 4numerous occasions emphasized the view
that “ we ftiusfc bfe eji
guard: ecgkm^t over&tressing the factor of




OTHER INVESTIGATIONS.

127

infection.” This conclusion certainly applies with particular force
to the lung diseases met with among granite workers. Investiga­
tions conclusively show that of the three factors generally considered
as predisposing to pulmonary ^tuberculosis—infection, heredity, and
environment—it is only the latter, and in a very restricted sense,
which applies to the mortality problem under review. Infection
probably occurs in the vast majority of cases in early infancy.
The later outbreak of the disease is attributable to diminished
resistance, and in industrial life perhaps there is no more potent
cause than lung injury, resulting from the inhalation of large quan­
tities of minute particles of inorganic dust.
INVESTIGATION OF MINERS’ PHTHISIS COMMISSION OF SOUTH
AFRICA.

It was the clear recognition of this viewpoint on the part of the
Miner’s Phthisis Commission of the Union of South Africa that made
possible the adoption of remedial measures which have been of direct
and far-reaching advantage to the industrial population. The report
of the commission, published in 1912, is one of the most notable
contributions to the knowledge of a question which is of world-wide
importance, wherever dust-producing occupations are carried on.
It would not be feasible on this occasion to review extensively the
findings of this commission, but the inclusion of the following obser­
vations may add to the practical value of the present investigation.
Regarding a differentiation of miner’s phthisis, it is said that “ the
disease known as miner’s phthisis, or more correctly as silicosis, has
been shown to be a chronic fibrosis of the lung due to the inhalation
of fine angular dust suspended in the mine atmosphere.”
M INERS’ PHTHISIS, OR SILICOSIS.

This is amplified by the further and particularly significant conclu­
sion that “ medical evidence has not disclosed the existence of an
appreciable amount of tuberculosis disease amongst miners.” After
reviewing the more important investigations made in South Africa,
Cornwall, and Australia, the general conclusions are summarized
in the statement (p. 7) that—
First, it is apparent that the excessive incidence of lung disease amongst miners
engaged in a certain class of metalliferous mining is not a feature peculiar to the mines
in the Transvaal, and although the extent and character of that incidence may vary
in detail in different mining communities the broad fact is well established of the
prevalence of fibroid phthisis as a specific occupational disease amongst metalliferous
miners working in hard rock.
Second, it is of the highest importance to note that these investigations have every­
where led to the same conclusions as to the nature and causation of the disease which
has come to be commonly known as miner’s phthisis, and the evidence they contain,
together with the very large local experience of- miner’s phthisis, has enabled us the
more readily to formulate a working definition of the disease we are asked to investi­
gate and to construct definite clinical standards for its identification and classification.
CONCLUSIONS OF PREVIOUS INVESTIGATIONS.

The miner’s phthisis here referred to would seem to be for all
practical purposes identical with the type of industrial lung disease
commonly met with among granite cutters and generally erroneously
diagnosed as pulmonary tuberculosis. Before proceeding to the
pathology and symptoms of the disease as laid down by the Miners’




128

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.

Phthisis Commission the main conclusions of previous investigations
may be quoted as a matter of convenient reference. These are
stated as follows:
(1) That the excessive mortality amongst certain classes of metalliferous miners has
been due to lung diseases, and particularly to the disease known as miner’s phthisis,
and that in regard to diseases other than those of the respiratory organs the mortality
of metalliferous miners as a class compares quite favorably with that of the general
male population.
(2) That this mortality has greatly increased in each locality since the general
introduction of rock drills into mining practice and falls most heavily upon rock-drill
miners; general miners also suffer, but to a less extent.
(3) That clinical and pathological evidence, supported by evidence relating to the
occupational conditions under which the disease arises, shows that the primary cause
of miner’s phthisis is the repeated inhalation over prolonged periods of the fine rock
dust generated in mining operations, that this cause produces reactive changes in the
lungs which are of the nature of a slow progressive fibroid change, and that upon this
condition tuberculosis infection becomes commonly eventually superimposed.
(4) That the objects to be aimed at in all measures to be taken to obviate the
incidence of the disease must be to prevent the generation and inhalation of rock
dust, to prevent the contamination of the mine air by the fumes of explosives and
by respiratory and other impurities, and to control the risk of the spread of tubercu­
lous infection amongst miners.
PATHOLOGY OF LUNG FIBROSIS.

The process of rock drilling here referred to is practically identical
with the use of pneumatic tools in stonecutting, carving, etc. It is
practically certain, however, that the latter processes are even more
injurious than the former. Broadly speaking, the duration of trade
life necessary to show the full effect of continuous and considei able
dust inhalation is probably the «ame, or, approximately, 20 years.
Considering now and very briefly the pathology of miner’s phthisis,
as defined in the report of the South African commission, the facts
may be briefly summarized as follows:
It [the disease] is primarily a chronic fibrosis of the lung, a chronic interstitial pneu­
monia, as it is technically described. The irritant properties of the fine dust particles
inhaled produce chronic catarrhal processes in the air cells and respiratory passages.
From these a certain proportion of the dust particles are taken up and pass into the
substance of the lung, where they produce a chronic inflammation, which results in
title production of fibroid changes around each focus of irritation. These changes
become in time distributed in varying degree throughout the whole lung substance
and in the fibrous framework of the lung and the pleura which invests it. These
fibroid areas increase in extent and ultimately coalesce to form patches of consolida­
tion, obliterating in the process the true lung tissue and gradually but inevitably
encroaching on the amount of normal lung substance available for respiration. The
process at once induces and is extended by the occurrence of recurrent “ colds,”
slight attacks of pleurisy, and localized catarrhal inflammations, and is aided, no
doubt, by exposure to sudden variation of temperature. The change is a diffuse
one affecting both lungs, but not always equally. It takes a considerable time,
commonly a#period of several years, to impair the working capacity of those affected.
It is not intrinsically an infective process, but is due to mechanical irritation, although
its progress may be and often is accelerated by inflammatory attacks due to bacterial
invasion. This is the primary condition found in all true cases of miner’s phthisis—
all are primarily cases of silicosis, which is the name given to the fibroid disease of
the lung caused by the inhalation of stone dust.

These observations clearly indicate the nontubercular nature of
fibroid phthisis, at least in its essential stage, when preventive meas­
ures are most likely to prove effective. It is emphasized in the sub­
sequent conclusions that the condition of simple fibrosis may exist
and progress for years, but that in the later stage of the disease
“ the lung so damaged is commonly invaded by the tubercle bacillus.
In at least a great majority of cases tuberculous infection becomes




OTHER INVESTIGATIONS.

129

toward the end superimposed upon the preexisting silicosis and the
symptoms and course of the disease become to a greater or less extent
altered accordingly.”
DIFFERENTIATION OF DISEASE SY M PTO M S

The symptoms of fibrosis of the lungs are stated by the commission
to be u slight shortness of breath and recurrent bronchial colds. The
general health is good, the working capacity is not interfered with.
A man may remain in this stage for a long period.” There is nothing
said here of expectoration, of loss of weight or loss of appetite and
rise in temperature, clearly indicating that a precise diagnosis would
differentiate the initial conditions of fibroid phthisis very readily,
but it is certain these symptoms increase: “ Cough—often a morning
cough and perhaps accompanied by sickness, commonly with a little
expectoration— distinct shortness of breath on exertion, a more fre­
quent liability to slight but obstinate bronchial attacks, and frequent
flitting pleuritic pains are the symptoms which first attract serious
notice. These are the symptoms when the condition is established.
The general health may not be noticeably affected, there may be no loss
of flesh, but there is now a definite impairment of working efficiency.”
SILICOSIS AND TUBERCULOSIS.

The report of the South African commission in this connection
points out that “ physical examination of such a typical case of
defined silicosis will show certain definite signs. Of these the most
obvious is impaired expansion of the chest and a characteristic rigidity,
especially of the upper portions on each side anteriorly.” This con­
dition has been described as follows:
“ The chest is remarkably motionless, the man seems deaf to the
request to draw his breath” ; and this is amplified by the statement
that—
The entry of air into the lungs is impaired— the breath sounds are diminished in
extent and volume and are commonly altered in character. Typically, one finds
a wavy, interrupted, lagging inspiration, the quality of the sounds is often harsh,
and all types of bronchovesicular breathing maybe found. True 1‘bronchial” breath­
ing is not common at this stage. There may be patches of impaired resonance to
percussion due to thickened pleura or small areas of consolidation; evidence of old
and recent local pleurisy is common, especially in the lateral regions of the chest;
bronchitic “ rhonchi” may be heard here and there; “ crepitation” is comparatively
rare. But the complete clinical picture is now unmistakable. In the stage of early
fibrosis one finds also, but to a lesser extent and degree, the cardinal signs of impaired
expansion of the chest, impaired air entry, and alteration in the character of the
breath sounds, with perhaps evidence of slight localized pleurisy.

It is not necessary to enlarge further upon the differential diagnosis
of fibroid phthisis and fibroid and pulmonary phthisis, but the
following quotation will conclude the clinical picture.
As the disease progresses to the advanced stage the cardinal symptom of shortness
of breath becomes more urgent and distressing, the cough more frequent, expecto­
ration may be more copious, but is still often slight. The patient becomes unable to
work—he loses flesh—his narrow, shrunken, rigid chest may scarcely expand at all
on breathing. The shoulders are hunched, the chest appears to be practically fixed
in the position of extreme expiration. The lij>s are bluish, the pulse rapid, the
expression anxious, the right side of the heart dilates under the strain.

To this admirable clinical description of an uncomplicated case
of fibroid phthisis is added the following observation on a superimposed
tuberculosis: “ Tuberculosis may supervene on this condition of




130

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

fibrosis at any stage, but it is not common to find it in association
with early or even with moderately advanced cases. It is in the
great majority of cases a terminal phenomenon attacking the sufferer
from fibrosis when that condition is already advanced. When that
occurs the downward progress of the patient is usually very rapid.”
GENERAL CONCLUSIONS.
The present investigation emphasizes the urgent need of a much
more comprehensive study of the predisposing factors responsible
for tuberculosis occurrence. Much of the literature on the subject
reflects hearsay or secondary evidence rather than original obser­
vations and extended personal experience. Many of the accepted
theories on tuberculosis are general principles deduced from experi­
ence entirely too limited for a broad generalization. This view is
clearly emphasized in such a work as The Shibboleths of Tubercu­
losis, by Dr. Marcus Patterson, medical superintendent of the
Metropolitan Asylum Board and late medical superintendent of the
Brompton Sanatorium. Dr. Patterson makes it clear that upon
many of the most important questions regarding cautions and
treatment qualified medical opinion is as yet far from being in entire
agreement. He himself concludes that the increase in the tuber­
culosis death rate since 1914 is attributable not so much to war
causes as to better diagnosis, a conclusion wholly unacceptable to
those who have considered the question in its larger aspects, for if
better diagnosis increased the death rate during 1915 to 1918 a
lesser degree of accuracy in diagnosis must, in part at least, account
for the material decrease in the disease during 1919-1921. The
theory of questionable accuracy in diagnosis is always acceptable to
those who have not made a thorough inquiry into all the facts, par­
ticularly the statistical intricacies of a highly complex medical prob­
lem.
CONTRADICTORY MEDICAL OPINIONS.

Medical men, unfortunately, often lack the requisite statistical
training and the time or the facilities for considering exhaustively
the underlying problem of collective disease experience. Trained as
they often are in minute laboratory research, they fail most con­
spicuously in being able to give due consideration to occurrences
represented as mass phenomena, intelligible only by means of a quali­
fied statistical analysis. The charge of inaccuracy in diagnosis is
often made in connection with medical controversies to set aside over­
whelming statistical evidence based upon the only records available.
These records in each and every case represent the last word of the
attending physician as regards the true cause of death, and while
obviously errors must occur and certainly do occur it is of the essence
of the statistical method that in the absence of a strong bias such
errors will tend to balance one another and will not impair materially
the general conclusions arrived at.
Death certificates rarely fail to disclose the general truth of a
given cause of death, however far they may fall short in matters of
detail or in absolute precision in bedside diagnosis. They may fail
correctly to state that the death was due to a tuberculous process
positively identified by the presence of the bacillus, but they will
rarely fail in disclosing the fact that the pathogenic process was one




GENERAL CONCLUSIONS.

131

of destructive lung injury often due to causes largely within human
control. It may be pointed out in this connection that in the judg­
ment of qualified authorities a positive tubercle-bacilli test of the
sputum is not in itself evidence of active tuberculous disease,
while, conversely, a negative tubercle-bacilli test is not necessarily
evidence that the disease is not present. All that is definitely
known, in the words of Dr. Patterson, is that “ the presence of bacilli
in the sputum will definitely prove infection but not activity.77 The
proof of such infection will, however, be of the utmost value in a
doubtful case of illness, where there are marked constitutional
symptoms and few physical signs. In the absence of an entire agree­
ment upon questions like the foregoing there must necessarily prevail
a wide diversity of opinion in death certification, but in the writer7s
judgment not sufficient to impair the value of such records for statis­
tical purposes. (See in this connection some very excellent observa­
tions on the etiology of tuberculosis, based upon an extended review
of Prof. Calmette7s recent work on “ Bacillary infection and tuber­
culosis in men and animals77 in the Boston Medical Journal, Decem­
ber 11, 1920; also an important letter on the “ Etiology of tubercu­
losis,77 by Major Greenwood, in the Lancet, December 4, 1920-A.)
RESULTS OF SOUTH AFRICAN MEDICAL RESEARCH.

Accepting, as it is believed one must, the statistical evidence of a
material increase in industrial lung disease among granite workers
during the last 15 or 20 years, in contrast to a marked decline in the
incidence of the disease among limestone and glass workers, there
remains a debatable question as to whether the disease reported as
pulmonary tuberculosis is not in the majority of cases a true form of
pneumoconiosis, or industrial lung disease, without evidence of
bacillary infection. The questions involved are not likely to be
solved by animal experimentation, but will require the methods of
the strictly scientific inquiry adopted by the South African Institute
for Medical Research. With particular reference to miner7s phthisis,
it may be pointed out in this connection that under the miner’s
phthisis act of South Africa, 1916, “ every European applicant for
employment underground in the mines of Witwater7s Rand is re­
quired to submit himself for medical examination at the bureau, the
object being to exclude from work underground any person who is
physically unfit for such work. In addition all miners employed
underground must be similarly examined at intervals of not more
than six months to ascertain whether or not they are suffering from
either tuberculosis or silicosis or both.77 The examination conducted
at the bureau is a very thorough one and embraces both clinical and
X-ray investigations. Such research is obviously called for in the
case of the granite workers of the Barre district, subject as they are
to one of the very highest death rates from pulmonary tuberculosis
on record for any industry or any section of the world. If the pres­
ent investigation could have been conducted along the lines adopted
by the South African Institute for Medical Research and the Miners7
Phthisis Medical Bureau of South Africa, much additional evidence
would have been available further to confirm the lamentable con­
clusions reached. As an illustration of the extraordinary thorough­
ness of the work of the Miners7 Phthisis Medical Bureau of South
Africa, it may be said that the office has a complete medical and




132

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

radiographic record of 35,816 miners and that since the inauguration
of the bureau in August, 1916, up to the 31st of December, 1919,
upwards of 11,500 examinations have been carried on. Largely as
the result of the work of the Miners’ Phthisis Medical Bureau the
incidence of silicosis among South African miners has decreased.
Even among native laborers, notwithstanding the continued preva­
lence of influenza, the death rate declined from 12.8 per 1,000 in 1910
to 2.6 per 1,000 in 1919. Is it too much to expect that workers in
the stone industry of the United States should receive the same qual­
ified medical consideration that is extended to native mine laborers
on the Rand ?
SOUTH AFBICAN SILICOSIS STATISTICS.

The disastrous experience of the last 15 years, involving the loss of
countless useful lives, is suggestive of the conclusion that if silicosis,
or pneumoconiosis, or whatever term may be acceptable, were recog­
nized as an industrial disease, entitling the person injured to adequate
pecuniary compensation, a material reduction in the death rate would
be only a question of time. This conclusion would involve the larger
question of adequate medical supervision and control of persons em­
ployed in connection with granite-stone cutting processes, more or
less in conformity to the methods adop.ted and found favorable in
South Africa. There may be included here a statement from the
annual report of Dr. W. Watkins-Pitchford, chairman of the Miners’
Phthisis Medical Bureau for the year 1919, who reports over 32,000
statutory clinical examinations and investigations: “ The prevalence
of pulmonary tuberculosis (pure or complicated by silicosis), as revealed
at the periodical examinations of 15,000 miners of European descent,
was at the rate of 1.14 per 1,000, as compared with 1.27 and 0.91 for
the two preceding years, respectively. The prevalence of silicosis,
either in a pure form or complicated by tuberculosis, was 5.53 per
1,000, as compared with 5.56 and 5.60 for the two preceding years.
As ascertained at the periodical examinations, the attack rate of
tuberculosis not complicated by silicosis was 0.255 per 1,000, as
compared with 0.259 for the preceding year.” In only one case
was pulmonary tuberculosis detected at the periodical examination
of a person who had passed the initial examination of the bureau.
The reports contain much additional information of the utmost
practical value, but it is possible to give only the concluding obser­
vation— that “ tuberculosis affecting the silicotic miner is relatively
noncommunicable to a healthy person,” a conclusion apparently in
full conformity to the facts found in investigations made into
family history of granite cutters dying from industrial lung dis­
ease in Barre, Yt. (See the Lancet, January 1,1921.)
BRITISH SILICOSIS ACT.

A similar act, or rather an amplification of the workmen’s compensa­
tion act of 1906, was adopted by Great Britain in 1918. No results
under this act are as yet available, but the measure clearly fore­
shadows a development of a new governmental policy in dealing
rationally, effectively, and equitably with the occurrence of indus­
trial disease directly traceable to continued and considerable dust ex­
posure. The scheme put ting into effect thesilicosis act of 1918requires
that “ every workman shall be examined at prescribed intervals, and




GENERAL

C O N C L U S IO N S ,

133

these examinations are to be made at the works unless the medical officer
otherwise decides. Any workman who at the commencement of the
scheme has been employed in the industry for more than 20 years is ex­
empt from these examinations, but newcomers must be examined within
three months of their commencing work, and if the medical officer
finds any workman to be suffering from silicosis or silicosis accom­
panied by tuberculosis to such a degree as to make it dangerous for
him to continue to work in the industry, he shall suspend the workman
from further employment.” Whether this regulation is sufficient for
the purpose only experience can demonstrate. It is highly sugges­
tive, however, that in 1919 there should have been issued the “ re­
fractories industries scheme,” which concerns the industrial manip­
ulation of material containing not less than 80 per cent of silica,
chiefly applicable to fire-brick manufacture and the quarrying and
dressing of hard stone, as well as to certain processes in potteries.
All workmen employed in such processes are to be examined once a
year and on certain additional occasions by a medical officer ap­
pointed by the secretary of state* It is of interest in this connec­
tion to quote from the Lancet of May 24, 1919, that it is to be
noted “ that the view that silicosis of itself can cause death is ac­
cepted” and “ failing a positive sputum test the,differentiation of
fatal silicosis from silico-tuberculosis must be difficult save by a
speedy post-mortem examination and animal inoculation.” The
Lancet, however, concludes that the various provisions for compen­
sation seem fair and that there is evidence of a sympathetic consid­
eration of the workmen’s lot. The scheme of the workmen’s compen­
sation silicosis act of 1918 was published as Statutory Rules and Orders,
1919,No. 12, under date of January 6. These observations emphasize the
direction along which lies the practical solution of the problem of an
excessive incidence of pulmonary tuberculosis or industrial lung
disease among granite workers. The conclusions, however, apply
to a much wider range of occupations in which the exposure to sili­
cosis dust is the direct,causative factor of an excessive death rate at
the period of life when continued duration is of the utmost economic
importance to the person concerned, the industry, and the State.
RECENT SILICOSIS INVESTIGATIONS.

Considerable progress has been made with technical investigations,
which, however, with regard to American experience, can not be con­
sidered final until the results of the investigation by the Bureau of
Mines are available. One of the most recent contributions on pul­
monary silicosis is an extended discussion by Dr. E. L. Middleton,
medical officer to the Welsh National Memorial (Tuberculosis) Associ­
ation, contributed to the Journal of Industrial Hygiene for March,
1921 (pp. 433-448). This admirable discussion includes a consider­
ation of the following industries: (1) Manufacture of silica bricks and
silica flour milling; (2) scythe-stone making; (3) lead mining; (4)
quarrying, and (5) stone dressing. A number of actual cases in each
of these industries are described, including 11 stone dressers, typical
of the class of people considered in the present inquiry. Under the
subtitle “ Pathogenesis” the writer presents his observations on air
pollution by dust, on the essential fineness of dangerous silica dust,
and on the specific qualities of silica as a disease producer. These
observations can not be conveniently reduced to the form of a broad




134

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

t

eneralization, but with reference to the fineness of dangerous silica
usts it is pointed out that “ the size of the silica particles is a con­
sideration of the utmost importance in the causation and prevention
of silicosis/7 for, he remarks, it follows that “ the naked-eye appear­
ance of the atmosphere of a workplace is no criterion of its safety,
for the most dangerous particles are invisible under good conditions,
and even much coarser contamination of air would be unrecognizable
in the deficient light of mines, kilns, and sheds.77 He concludes in
this connection that “ the dust which causes the lung changes in
silicosis is, then, the very fine silica particles of less than 12 microns
and averaging little more than 1 micron in size.77 This statement is
amplified by the additional observation that “ recent researches and
the observations of numerous investigators indicate that the purity
of the silica dust must be recognized as a factor of prime importance
in the causation of silicosis.77 He deplores the lack of mortality
statistics of silicosis, in connection with which it may be said that
deaths from fibroid or miner’s phthisis are rarely returned as such, but
are generally reported under the designation of pulmonary tubercu­
losis, That the specific reporting of such cases would not be diffi­
cult is emphasized, by the official reports of the registrar general of
Queensland, who^ for some years past has returned deaths from
miner’s phthisis among nontuberculous respiratory diseases. The
Queensland returns indicate an increasing mortality from this affec­
tion, from a minimum of 19 deaths in 1911 to 46 deaths in 1918.1
The classification in the international list of miner’s phthisis under
97-A, in class 4, or diseases of the respiratory system, precisely em­
phasizes the practical importance of the conclusion that the alleged
form of tuberculosis met with among granite-stone workers is, in the
majority of cases, a nontuberculous type of fibroid lung disease.
In considering the pathology of pulmonary silicosis Dr. Middleton
points out that “ the weight of the lung is always increased when sili­
cosis is present,77 and that “ increase in weight may amount to twice
the normal weight in advanced silicosis, when complications such as
edema and pneumonia are included.77
This statement is amplified by an observation derived from the
study by the South African Institute for Medical Research, accord­
ing to which “ (1) the total weight of silica in the diseased lungs was
much higher (from 2.8 to 9.6 grams) than in the normal lung (0.55
gram), and (2) the proportion of silica in the ash of the diseased
lungs was much greater (from 29 to 48 per cent) than in the normal
lung (14.7 per cent).77
In a brief discussion of the symptoms of pulmonary silicosis atten­
tion is directed to the length of time intervening between onset and
serious disease manifestations. This period was found to have been
an average of 14.26 years, and although a relatively small number of
cases were under observation the duration of trade-life exposure was
found to be longest in the case of stone masons (equivalent to stone
cutters) or 22.3 years. This conforms almost exactly to the American
experience, which places the duration at about 21 years. The obser­
vations on symptoms include important remarks on dyspnea, cough,
influenza and colds, hemoptysis, and other symptoms, a detailed
discussion of which does not seem to fall within the province of this
inquiry.
i Vital Statistics of Queensland, 1919 (No. 60), Brisbane, 1921.




135

GENERAL CONCLUSIONS.
PHYSICAL SIGNS OF SILICOSIS.

As regards physical signs, it is, however, of importance to point
out that u silicosis is a disease only according to the degree in which
it departs from the accepted normal oi adultlife/^ for, it is said, “ the
danger and difficulty, of course, lie in the time which it takes for the
inhaled dust to produce the pathological changes in the lung to which
the physical signs and symptoms are due.” The urgency of early
diagnosis is emphasized in the statement th at({routine examinations
in dusty industries are, therefore, greatly to be desired. The physical
signs, however slight, at each examination should be charted and
variations in later findings carefully noted and their value assessed.”
The commonest early physical sign of pulmonary silicosis is found
in the right mammary region, or above the fourth rib, where the
breath sounds may be of a harsh character and rather puerile in
quality. Radiography is referred to as a valuable addition to the
ordinary means of diagnosing silicosis, giving useful help in detecting
the presence of tuberculous foci and other complications. The im­
portance of radiography as an auxiliary aid in determining the true
extent of lung damage as the result of continuous dust inhalation
is freely recognized by all who have given the subject qualified
consideration.
DESCRIPTIVE CASES.

The investigation by Dr. Middleton includes an extremely valuable
account of descriptive cases suggestive of a similar portrayal of the
clinical material available for this country. In the aggregate, 57
cases were subjected to specialized consideration, with results as
shown in Table 80.
T a b le

8 0 .—CASES OF TUBERCULOSIS F O L L O W IN G EM PLOYM ENT IN D U STY OCCUPA­
TIONS.

Occupation.

Num­
ber of

Employment in industry,
in years.

Shortest. Longest. Average,

Silica-stone workers___
Scythestone workers. . .
Quarrymen...............
Lead miners..............
Stonemasons.............

16

3.75

2.5

21.0

4.0
15.0

18. 75
22.3

Total...................

Average Initial symptom.
Average time in
industry
age at
before
onset, in
onset, in
years.
Dyspnea. Cough,
years.
37.0
38.66
41.83
44. 41
40. 25

13.2
17.2
23.7
22.4

40.41

18.95

Other symptoms.

Av­
Tu­ Family
A v­
erage
bercle history
erage term
of
Fatal
bacilli of tu­
age at
Hemop­ Night Weak­ Wast­ in spu­ bercu­
death, invalid­
ism,
in
ing.
tysis. sweats. ness.
tum.
losis.2
in years.
years.

Silica-stone workers___
Scythestone workers.. .
Quarrymen...............
Lead miners..............
Stonemasons.............
Total...................

5(4)
4

8
4
5
12
6

19

35

3$

2 ( 2)

47

21

1 Weeks.
a Numbers in parentheses are additional cases with doubtful family histories,
s Months.




39.5
48. 75
44.2
48. 58
46.16

1.83
1.75
2. 08
1. 58
»11. 33

A vduration of
symp­
toms,in
years.
3.8
3.5

2.5

3. 75
6.25

1“$ 6

DUST PH TH ISIS IN THE GftANITE-SEONE INDUSTBY.

This table, aside from its intrinsic value, is suggestive of the clinical
classification most likely to prove useful for practical medical and
preventive purposes. It is shown that for all occupations the average
age at death was 45.5 years, the average duration of invalidity
19.45 months, and the average duration of symptoms 4.0 years.
On the supremely important question of prognosis it is said that—■
With, a fibrosis sufficiently extensive to affect more than a minimum amount of air
tissue a progressive course of symptoms is to be looked for. The amount of involve­
ment necessary before definite disease can be considered permanent appears to vary
with the individual. * * * According to the exposure, on the one hand, and the
efficiency of the natural defensive mechanism, on the other, the lungs become aged
by the accumulation of dust and the resulting fibrosis. The term “ silicosis” therefore
is relative and implies that the sufferer has exceeded the limits of average balance
between inhalation and elimination, with the result that a deleterious accumulation
has accrued to his disadvantage.

Following some very interesting general observations (which,
however, can not here be included), it is said:
From the onset of symptoms until death the period of time which can be called the
illness varies widely. The reservation regarding the actual onset and the admitted
onset must be kept in mind, as the latter only is available to the clinician. Longest
in the stonemason series, the average duration of symptoms in 6 fatal cases among
these workers was six and one-fourth years, in 12 lead miners three and three-fourth
years, in 8 silica workers three and three-fourth years, in 4 scythestone makers three
and one-half years, in 5 quarrymen two and one-half years.

PRIM ARY IM P OUT AN CE OF SILICOSIS.
Considering the occurrence of silicosis with tuberculosis, it is said:
The most important variation in the course of the disease is the occurrence of tuber­
culosis. While there is evidence that tuberculosis may coexist with silicosis without
producing any apparent alteration in the course of the disease, in the majority of in­
stances the development of tuberculosis is along a different line and produces definite
evidences of its presence. In the earliest cases of silicosis, and especially in young
subjects, the disease when first seen may be indistinguishable from ordinary tuber­
culous phthisis. The superadded disease has produced symptoms before the ante­
cedent silicosis has developed sufficiently to demand medical attention’ hence it ia
missed.

DANGER OF ERRON EO US CONCLUSIONS.

The foregoing observations are of extraordinary practical impor­
tance in view of the prevailing nonrecognition of the distinction
pointed out in the large majority of cases now diagnosed as pulmonary
tuberculosis. Attention is drawn to the influence of each of the two
conditions on the other, which, when existing together, may give
some information, “ for, as has been mentioned before, the silicotic
process is hastened in the presence of tuberculosis, and the changes
due to it are unevenly distributed throughout the lung or lobe.
Hence an excess of activity in the course of silicosis, with a develop­
ment toward a tuberculous type, gives an indication which is obvious
enough. More and more such a case approaches the ordinary tuber­
culous disease as it advances, with the wasting, lassitude, pyrexia,
night sweats, and increase of cough and expectoration found in the
common ulcerative chronic tuberculosis.”
These observations explain the perfectly natural assumption that
in a large majority of cases the type of disease dealt with in its final
stages is a true form of tuberculosis, without an appreciation of the
fact that in all probability the disease in its initial stages, when




GENERAL CONCLUSIONS.

137

preventive measures would be most effective, is a case of non­
tuberculous respiratory disease. Dr. Middleton reemphasizes this
conclusion as follows:
The occurrence of tuberculosis has the effect of carrying the disease to a fatal issue
more rapidly than when this complication is absent. In 15 cases in which tubercle
bacilli were found in the sputum the average duration from the onset of admitted
symptoms was 3.17 years; in 20 cases in which tubercle bacilli were not found the
average duration was 4.62 years. ^ The difference as stated is less than it should be,
as several cases of shortest duration in the latter group were certainly tuberculous,
though no opportunity was obtained for sputum examination.

In concluding the foregoing observations on the symptoms and
physical signs of pulmonary silicosis, Dr. Middleton takes occasion
to say:
It might, of course, be argued that cases of pulmonary tuberculosis occurring in
young persons exposed to silica dust are ordinary cases of that disease without reference
to the industrial environment, and in some cases this may be so. It has been pointed
out, however, by many observers that the inhalation of silica dust predisposes to the
development of tuberculosis, and it must be admitted that this baneful influence
may have been at work in precipitating the onset of pulmonary tuberculosis, although
no characteristic symptoms of silicosis had been observed.
RESTATEM ENT OF SILICOSIS CONCLUSIONS.

The results of this investigation by Dr. Middleton, which may be
considered epoch making in its practical bearing upon the larger
problem of prevention and control, are summarized in the following
final conclusions:
1. Silicosis is caused by the inhalation of minute particles of dust of high silica
content.
2. The finest particles are most directly injurious, as they reach the lymphatic
channels of the lung., producing progressive fibrosis; the dust is most dangerous at the
first moment of generation, before dampening or agglutination has occurred.
3. The disease produced can be diagnosed from physical signs—in some cases
before the patient has become aware of definite symptoms.
4. Silicosis predisposes to tuberculosis of the lung, as a result of the changes pro­
duced in the lung. It may, however, exist and prove fatal without any definite
evidence of a superadded tuberculous infection.
5. The only means of combating the disease is by projxhylaxsis—in preventing
the generation of dust at its source, in obviating its inhalation by the use of masks,
and in excluding any affected persons when the condition becomes recognizable.
6. The prophylactic measures should be carried out in all industries where the
inhalation of dust of high silica content is a contingent danger.




APPENDIXES.
APPENDIX A.— INQUIRY BLANK USED IN THIS INVESTIGATION.
STONE INDUSTRY.
P ersonal

R ecord.

Name........................................................................................................................................
Present address.......................................................................................................... ...........
Age.............................. Sex.............................. Race.....................................................
Married, single, widowed or divorced...............................................................................
Country or State of birth.....................................................................................................
Height........................................................ Weight............................................................
OCCUPATIONAL H ISTORY.

Industries employed in, prior to present employment. ,
Exact occupation followed in each industry................................................................
Time in each occupation...................................................................................................
Exact occupation now followed.......................................................................................
Length of employment in present occupation: Yrs.......................... Mos.............
Additional occupations now followed.............................................................................
Vacation time last year:
Weeks.......... Days.
Involuntary idleness last year:
Weeks.......... Days.
Absence from work on account of sickness last year:
Weeks.......... Days.
PRESENT W O RK ING CONDITIONS.

Tools used: Hand.................................................
Pneumatic...........
Type of pneumatic tool used........................................ .........................
Cutting process: Dry............................................. Moist....................
Provisions for removal of dust................................................................
Provisions against inhalation of dust....................................................
Are respirators used?.................................................................................
Ventilation: Good.............................. Fair.............................. Bad
Method followed in cleaning up.............................................................
H ome

H y g ie n e .

OUTSIDE SANITAR Y CONDITIONS.

Good......................................

Fair......................................

Bad............

INSIDE SA N IT AR Y CONDITIONS.

Light and air: Good..............................
Cleanliness:
Good..............................

Fair..............................
Fair..............................

Bad.
Bad.

ROOM ACCOMMODATION.

Total number of rooms.................................. Persons in household...
Average number of persons per room..................................................
138




139

APPENDIX B.
TUBERCULOSIS IN FAM ILY.

At present diseased.
Relation to head of
family.

Sex.

Suspected.

Age.
Active.

Formerly a
patient.

Arrested.

Remarks:

APPENDIX B.— MEDICAL BLANK RECOMMENDED.
Physical and X-ray examinations
Dr.......................................................

Name of plant.........................
Location...................................

STONE INDUSTRY.
PERSONAL DATA.

1
2
3
4
5

Name............................................................................................................................
Address.........................................................................................................................
Age................................................................................................ ..............................
Birthplace of workman........................................................... .................................
Birthplace of workman’s mother.......................................... ................................

6
7
8
9
10

Firm, or place of work..............................................................................................
Kind of stone worked...........................„•..................................................................
Exact occupation.......................................................................................................
Years followed............................................................................................................
Former occupations...................................................................................................

11
12
13
14

Types of pneumatic tools used...............................................................................
How many years?......................................................................................................
What particular operation is most dust producing?..........................................
Is general dust exposure apparently harmful?...................................................

15
16
17
18
19
20
21
22
23

Height (standing)......................................................................................................
Weight (ordinary clothing)......................................................................................
Chest— Full inspiration.................................. Full expiration.........................
Any evidence of chest deformity?.........................................................................
Pulse............................ Respiration............................ Temperature.............
Muscular development—Very strong.............. Normal.............. Very poor
Loss of weight— Yes................................................. No...................................
Loss of strength—Yes.................................................. No...................................
Is workman a habitual nose breather?; ...............................................................

TRADE LIFE.

DUST EX PO SU R E.

PHYSICAL DATA.

61928°— 22— Bull. 298-------10




140

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.
CLINICAL B ATA.

24 Chest— Palpation.....................................................................................................
Percussion...................................................................................................
Auscultation...............................................................................................
25 Night sweats—
Yes............................................... No.............................
26 Cough
Yes............................................... No.............................
27 Pain in chest—■
Yes............................................... No.............................
28 Shortness of breath—Yes............................................... No.............................
29 Expectorations—
Yes............................................... No....................... .
30 X-ray examination— Positive.................. Doubtful.................. Negative.
31 Preliminary clinical diagnosis..............................................................................
DIAGNOSIS.

32
33
34
35

Indicated present capacity for work— Good.............. Fair.............. Bad..
Diagnosis of silicosis— Positive................ Doubtful................ Negative..
Diagnosis of tuberculosis— Positive.............. Doubtful.............. Negative.
Remarks.........................................................................................................................

APPENDIX C.— INCIDENCE OF PULMONARY TUBERCULOSIS IN TRADES
WITH EXPOSURE TO MINERAL DUST.1
The following summary has been derived from a large variety of official sources and
is intended to facilitate the technical study of the dust aspects of the problem of
respiratory diseases in trades with exposure to inorganic dust. The analysis includes
(a) the occupation; (6) the composition of the dust; (c) the death rate from pulmonary
tuberculosis per 100,000 exposed to risk; (d) the locality or country; and (e) the source
of information.
The arrangement of the occupations is as nearly as possible according to the nature
of the dust exposure, beginning with knappers and ganister workers and miners,
continuing with sandstone workers and granite cutters, stonecutters generally, includ­
ing marble workers, and concluding with slate and limestone workers and miscella­
neous (but chiefly mining) employments.
i Prepared by Sylvester Schattschneider.




Table 1.—M ORTALITY FROM PULMONARY TUBERCULOSIS IN SPECIFIED OCCUPATIONS W IT H EXPO SU RE TO METALLIC AND M IN ER AL DUSTS.

Occupation.

Flint knappers..

Composition of dust.

Year.

Free silica, 100 per cent..

Death
rate per

4.100.0

Brandon, England...........
Don Valley-Stocksbridge..

2.229.0
3.700.0

Tin miners..................

Tinstone, granite, and quartz.
Free silica, about 75 per cent.

1.760.0

Cornwall.................. .

Gold miners,..................

Gold-bearing quartz.
about 90 per cent.

1.270.0

Bendigo, Australia..

Gritstone workers.

Free silica, about 96 per cent.

1901-1910

1.370.0

Bakewell registration dis­
trict, Derbyshire.

1901-1910

700.0-

Derbyshire.............................

1905-1909

910.5

United States and Canada .

1910-J914
1191.5-1918
1910-1911

854.0
1,029.9

2 164.0

Gritstone workers (some in
limestone).
Sandstone cutters.....................
Do.
Do.
Do.

.

.do.
.do..
Wertheim, Germany.

Free silica, up to 95 per cent..

1.670.0

Grinshill.....................

Do.
Do.

. . . d o ........................................
1880-1911

1.340.0
1.671.0

Derbyshire................
Clive and Grinshill..

Do.

Mostly quartz (silica) -

Do......................
Sandstone workers.

1880-1911

1.310.0
1 120.0

Sandstone quarrymen..
Do.............................

1880-1911

990.0
794.0

Sandstone masons..

1 Exclusive of the last three months of 1918.




1.370.0

.

Great Britain.. .......
New South Wales...
Clive and Grinshill..
New South Wales..
Clive and Grinshill.

Report on the prevalence of phthisis among quarry
workers and miners, by Sidney Barwise, M. D., B. Sc.,
D, P. B!., Derby, J913.

Do.

Mortality experienee of the Journeymen Stone Cutters’
Association of North America.
D o.

Do.
Die Steinindustrie im Grossher^ogtum Baden, by Regierungsrat Dr. Fdhlisch, Karlsruhe, 1913.
Annual report of the chief inspector of factories and
workshops for the year 1912, p. 216, London, 1913.
Do,
Minutes of evidence taken before the Royal Commission
on Metalliferous Mines and Quarries, V ol, III, p. 72,
London, 1914.
Second report of the Royal Commission on Metalliferous
Mines and Quarries, i914.
Interim report of Board of Trade, Sydney, 1918.
Minutes of evidence taken before the Royal Commission
on Metalliferous Mines and Quarries, Vol. I ll, p. 70,
London, 1914.
Interim report of Board of Trade, Sydney, 1918.
Minutes of evidence taken before the Royal Commission
on Metalliferous Mines and Quarries, Vol. I ll, p. 72,
London, 1914.

G,

Free silica, about 95 per cent.
Free silica, about 98 per cent.

Milroy Lectures (1915), Industrial pneumoconiosis,
with special reference to dust phthisis, by Prof. Edgar
L. Callis (Qxon).
Journal of the Sanitary Institute, Vol. X X I , 1899, Part
I, p. 66,
The influence of dust inhalation on the incidence of
phthisis, by Prof, Edgar L. Collis, The Lancet, Jan.
22,1921, p. 179.
Report on the health of Cornish miners, by J, S, Hal­
dane, M, D ,, F, R , 3., Joseph S, Martin, and R. Arthur
Thomas, London, 1904.
Report of an investigation at Bendigo into the preva­
lence, nature, causes, and prevention of miner’s phthisis,?Tby Walton Summons, M. D,, B, S., Melbourne,

A P P E N D IX

Ganister miners._____

Ganister brickmakers.

Free silica,

Source of information.

Locality or country.

100, 000.

Concluded.

Rock choppers and sewer min­
ers.

Sandstone (silica) and shale...........
Feldspar, mica, and about 30 per
cent quartz (silica).

Year.

740.0
1895-1899

1900-1904
Do
..................................
1905-1909
Do
......................... ....... do.......
........................... 1910-1914
Do........................................... ....... do.............
Do........................................... ....... do...........................
i 1915-1918
Do........................................... Free silica, about 30 per cent.
Feldspar, mica, and about 30 per
cent quartz (silica).

1900-1909
1879-1890

Do........*..................................
Do...........................................

1889-1900
1908-1911

Do...........................................

1890

Do...........................................

1900

Stone, slate quarriers..................

1890-1892

Do...........................................

1900-1902

Slate quarriers and mill workers

Chiefly silicate of aluminum...........
1900-1906

Do. . .
.........
1905-1911
Do. . ..
........ ....... do...........................................
1900-1911
Limestone cutters....................... Calcium carbonate, with an in­ 1905-1909
considerable amount of silica.
Do...........................................
...d o .......
....................... 1910-1914
Do........................................... ___do.................................................. 11915-1918
Free silica, none, or less than 1 per
Limestone masons.. .
cent.




New South Wales..................

Interim report of Board of Trade, Sydney, 1918.

Mortality experience of the Granite Cutters’ Interna­
tional Association of America.
Do.
453.7 ....... do........................................
Do.
611.6
Do.
802.2 ....... do........................................
Do.
1 056. 7 ....... do........................................
Annual report of the chief inspector of factories and
’ 620.0
workshops for the year 1912, p. 216, London, 1913.
570.0 Aberdeen................................. Report by the medical officer of health of the city of
Aberdeen for the year 1909. Matthew Hay, M. D .,
L. L. D.
838.7 Switzerland............................. Ehe, Geburt und Tod in der schweizerischen Bevolkerung, 1879-1890, Part III, p. 103, Bern, 1903; 18891900, Part V , p. 283, Bern, 1916.
833.2 ....... do........................................
Do.
665.9 Holland.................................... Archiv fur Soziale Hygiene und Demographie, vol. 13,
Nos. 1 and 2, pp. 43-97, Leipzig, 1919.
435.8 Registration area of United Eleventh Census of the United States, 1890, Vol. V I,
Vital Statistics, Part I, p. 143.
States.
540.5 ....... do........................................ Twelfth Census of the United States, 1900, Vol. HI, Vital
Statistics, Part I , p. cclxxxv.
362.5 England and Wales...........
Supplement to the fifty-fifth annual report of the regis­
trar general of England and Wales, Part II, p. 137,
London, 1897.
230.0 ....... do.................................
Supplement to the sixty-fifth annual report of the regis­
trar general of England and Wales, Part II, p. 143,
London, 1908.
180.0 Merionethshire, Wales.......... Report o f the departmental committee on Merioneth­
shire slate mines, 1895.
202.0 Festiniog, Wales; Oakeley Minutes of evidence taken before the Royal Commission
on Metalliferous Mines and Quarries, Vol. Ill, p. 114,
quarries.
London, 1914.
280.0
d o ....
Do.
250.0
do___
Do.
626.8 United States and Canada . . Mortality experience of the Journeymen Stone Cutters’
Association of North America.
362.6 ....... do........................................
Do.
425.5 ....... do........................................
Do.
200.0 Derbyshire............................... Annualreport of the chief inspector of factories and work­
shops for the year 1912, p. 216, London, 1913.
432.0

New England States.............

INDUSTRY,

Slate quarriers.............................

Source of information.

GRANITE-STONE

Stonecutters (inclusive of mar­
ble workers).

Locality or country.

IN' THE

Granite rmttp.rs p/nd masons__

Death
rate per
100,000.

PHTHISIS

Composition of dust.

DUST

Occupation.

142

T a b le 1 .— M ORTALITY FROM PULMONARY TUBERCULOSIS IN SPECIFIED OCCUPATIONS W IT H EX PO SU R E TO METALLIC AND M INERAL DUSTS—

Limestone quarriers and work­
ers.

1901-1910

171.0

Limestone workers...
Limestone quarriers..

1901-1910
1900-1912

152.0
150.0

Limestone maftons.........
Limo and brick burners.

1900-1912
1879-1890

140.0
228.7

1889-1900

213.9

Do.
Gypsum, cement, and asphalt
workers.
Lead miners............................ Lead ore, limestone, chert, and
quartz (silica).
Do..

Chiefly iron ore and limestone..
___ do............................................
Carbon..........................................
___ do............................................
____do............................................

Employees of ax factory, pol­
ishers and grinders.

1900-1902

392.8

1890-1892
1900-1902
1890-1892
1900-1902
1901-1910

140.3
153.1
132.4
100.6
68.0

1900-1919

1.900.0

Steel and quartz. Free silica, 50
to 100 per cent.
Steel, emery, etc. Free silica,
none.

650.0

1910

1.480.0

1910

580.0

England and Wales............... Supplement to the fifty-fifth annual report of the regis­
trar general of England and Wales Part II. London,
1897.
Supplement
to the sixty-fifth annual report of the regis­
....... do........................................
trar general of England and Wales, Part II, London,
1908.
Do.
....... do.......................................
Do.
....... do........................................
Do.
....... do.......................................
Do.
....... do.......................................
Clay Cross, Derbyshire......... Report on the prevalence of phthisis among quarry work­
ers and miners, by Sidney Barwise, M. D., B. Sc.,
D. P. H ., Derby, 1913.
Connecticut ax factory......... Dr. W . Herbert Drury Yale School of Medicine. Indus­
trial tuberculosis and the control of the factory-dust
problem,by C. E. A. Winslow, D. P. H ., and Leonard
Greenburg, C. E .
....... do........................................ The Journal of Industrial Hygiene, Vol. II, No. 9, 1921,
p. 340.
Sheffield.................................... Annual report on health of the city of Sheffield for the
year 1910, p. 15. H. Sourfield, M. D.
Do.
____do........................................

O.

Cutlers (metal)...........................

534.9

1900-1919

Employees of ax factory (all)..
Grinders (metal).......................

191.5

1890-1892

APPENDIX

Ironstone miners.,
Do.................
Coal miners..........
Do.................
Do..................

.do..

1889-1900

Report to the Derbyshire County Council on the preva­
lence of phthisis among quarry workers and miners,
by Sidney Barwise, M. D ., B. Sc., D. P. H ., Derby,
1913.
Do.
....... do.......................................
Isle of Portland, England. . . Annual report of the chief inspector of factories and work­
shops for the year 1913, p. 149, London, 1914.
Do.
....... do.......................................
Switzerland............................ Ehe, Geburt und Tod in der schweizerischen Bevolkerung, 1879-1890, Part III, p. 103, Bern, 1903.
....... do....................................... Ehe, Geburt und Tod in der schweizerischen Bevolkerung, 1889-1900, Part V , p. 283, Bern, 1916.
Do.
....... do........................................

1Exclusive of the last three months of 1918.

143




144

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.
APPENDIX D .—MINERALOGY OF THE DUST PROBLEM.

To facilitate the technical consideration of some of the questions discussed, the
following observations on the primary mineral composition of the “ dark Barre"
granite may prove useful. Reference may be made to Bulletin 132, on Siliceous Dust
in Relation to Pulmonary Disease, published by the Bureau of Mines in 1917. Other
important works which have been consulted are a Treatise on Rocks and Rock Min­
erals, by Pirsson, New York, 1910' Chamberlin and Salisbury's Geology, Vol. I, New
York, 1909 (Chap. VII) and An Introduction to Geology, by Wm, B. Scott, New York,
1909 (Chap. A and Chap. X).
The following tabular analysis shows the specific characteristics of the feldspar
(65.5 per cent), quartz (26.6 per cent), and mica (7.9 per cent) in the granite quarried
in the Barre district, Y t .:
T able 1.—SPECIFIC CHARACTERISTICS OF THE STONE Q U AR R IED AN D M A N IP U L A TE D
IN THE BARRE, DISTRICT, V T .

Mineral element.

Hard­
ness.

Tenacity.

Fusibility.

Brittle-----

A fine splinter fuses before
the blowpipe with diffi­
culty.
Fuses at 3.5 to a clear or
glasslike enamel.

Not acted upon by ordinary
adds to an appreciable de­
gree.
Not materially acted upon
by acids.

Brittle to
tough.

Infusible before the blow­
pipe.

Insoluble in all acids except
hydroflouric.

2.5-3

Tough.......

Completely decomposed by
boiling sulphuric acid.

2-2.5

Tough___

Whitens before the blow­
pipe and fuses on the
edges when in thin
scales.
Whitens before- the blow­
pipe and fuses, on thin
edges to yellowish glass.

Feldspar:
Orthoclase (a potassi- 6-6.5
um-aluminuin sili­
cate).
Oligoclase (a sodium6-7
calcium-aluminum
silicate).
7
Quartz (silica)......................
Mica:
Biotite (a potassiumaluminum-magnesi­
um-iron silicate).
Muscovite (a potassium-aluminum sili­
cate).

Brittle___

Solubility.

Insoluble in acids.

The technical terms used are explained as follows:
Hardness.— By the “ hardness” of a mineral is understood the resistance which it
offers to abrasion. The degree of hardness is determined by observing the ease or
difficulty with which one mineral is scratched by another or by a file or knife.
In minerals there are all grades of hardness,, from that of a substance impressible
by the finger nail to that of a diamond. To give precision to the use of this character,
the following scale of hardness, introduced by Mohs, has been generally adopted:
1, Talc; 2, gypsum; 3, calcite; 4, fluorite; 5, apatite; ft, feldspar (orthoclase); 7, quartz;
8, topaz; 9, sapphire; 10. diamond.
The point of a pocketknife blade is ordinarily tempered to a hardness of a little over
5, and common window glass is of a hardness of about 5.5.
Fusibility.—All grades of fusibility exist among minerals, from those which fuse in
large fragments in the flame of the candle (stibnite) to those which fuse only on the
thinnest edges in the hottest blowpipe flame (bronzite), and still again there are a
considerable number which are entirely infusible (e. g., corundum).
The following scale af fusibility, proposed by von KobelJ, is- commonly in use:
1, Stibnite; 2, natrolite; 3, almandine garnet; 4, actinolite; 5, orthoclase; 6, bronzite.
A few additional references are the following: The Granites of Vermont, by T.
Nelson Dale, U. S. Geological Survey, Bui. 404, Washington, 1909; Common Min­
erals and Rocks, by R. D. George, Colorado Geological Survey, Bui. 12, 1017; A Text­
book of Mineralogy, by Edward Salisbury Dana, 17th ed.r 1893; A System of Mineralogy, by James Dwight Dana, I5th ed., 1877; The Nonmetallic Minerals, by George
P. Merrill, 2d ed., 1910; Manual oi Mineralogy and Petrography, by James D. Dana,
7th ed., 1889.




APPENDIX E.
APPENDIX

E.— ANALYSIS OF GBANITE- STONE DUST.
MONT, AND ABERDEEN, SCOTLAND.)

145
(BAR&E, VER­

The Chemical Division of the Pittsburgh Experiment Station of the Bureau of
Mines has completed a preliminary report on the rock-dust investigation undertaken
at Barre, Vt. The report is by Dr. Herbert Insley of the Bureau ©f Mines, amplified
by a paper on comparative tests of air dustiness by S. H. Katz and L. J. Trostel of the
technical staff of the Pittsburgh Experiment Station, which has been printed in the
Journal of the American Society of Heating and Ventilating Engineers, July, 1921.
The analysis of the rock dust obtained at Barre was found to disclose the presence of
only biotite, feldspar, and quartz in quantities sufficiently large to justify considera­
tion as possible direct or contributory causes of dust phthisis. Following are extracts
from Dr. Insley Js report, of which a manuscript copy has been ldndly placed at the
disposal of the author by Mr. A. C. Fieldner, supervising chemist of the Pittsburgh
Station:
Thin sections of Barre granite for petrographic study were made from chips collected
in the coarse material from the vacuum ventilation system at one of the plants. These
chips are probably fairly representative of the ‘ ‘ dark” Barre granite, the type of
rock on which the three plants were working exclusively at the time of the investi­
gations.
The essential constituents of the “ dark ” Barre granite are potash feldspar (orthoclase
and microcline), quartz, biotite, and limesoda feldspar (oligoelase-albite to oligoclase).
Accessory minerals, magnetite, titanite, allanite, etc., are not common.
The orthoclase is more or less altered and sericitized and in places alteration has
gone on to such an extent that very little of the primary orthoclase remains. Micro­
cline, on the other hand, is usually fresh and unaltered. Quartz grains show the
effects of strain by the marked undulatory extinction and the pronounced cracks
present. Secondary quartz is present as a cavity filling. Biotite was evidently
one of the first minerals to crystallize from the molten magma, for it is found inclosed
in both quartz and feldspar. The biotite is usually fresh, although sometimes slightly
altered to chlorite.
In order to determine the relative amounts of the essential minerals present in the
granite, two methods were tried. The Rosiwal method on a thin section of the granite
was first tried, using a low magnification (about 30 diameters). An average of 10
fields was taken, but the difference between individual analyses was so great, the
greatest difference being about 39 per cent, that the method was discarded as being
too inaccurate.
For the second method, a large number of the chips of the same material from which
thin sections were made were crushed to pass through a 200-mesh screen. The
crushed and screened material was thoroughly mixed, a small portion was placed
on a microscope slide and immersed in a liquid of known index of refraction. The
microscope was used with a photomicrographic camera, a plain glass plate to which
tracing paper was attached being substituted for the ground glass plate. The lens
system and camera length used gave a magnification of about 300 diameters. The
image of the grains on the thin paper were traced and then cut out. The pieces of
paper representing grains having an index of refraction higher than the liquid m which
they were immersed were weighed separately from those having an index lower than
the liquid and the relative percentage of the two calculated. The index of refraction
of the liquid was 1.555. Another slide was prepared in which the grains were im­
mersed in a liquid of index 1.545, and the same procedure of tracing and weighing was
repeated. By observing the Becke line at the borders of the grains when immersed
in the liquid with an index of 1.555, biotite could be distinguished from quartz and
feldspar. When immersed in the liquid with index of 1.545, biotite and quartz
could be distinguished from feldspar. Five analyses were made with each liquid,
and the average of each set calculated. The results gave the volume percentages of
biotite, quartz, and feldspar (orthoclase, microcline, and plagioclase). There was no
attempt made to determine the relative quantities of the different kinds of feldspar
present, but in all the analyses of the chips, as well as of the dust samples, the per­
centage of plagioclase was very much less than the percentage of orthoclase and micro­
cline. The volume percentages obtained were recalculated to weight percentages by
multiplying by the specific gravities of the minerals. The specific gravity of biotite
was taken as 3, that of quartz as 2.65, and that of feldspar as 2.57. In no case
were two analyses found which differed by more than 10 per cent.




146

DUST PHTH ISIS IN THE GRANITE-STONE INDUSTRY.

The report by Dr. Insley continues as follows:
Seven samples of rock dust obtained from various localities in the stone-cutting
plants at Barre, Vt., were examined with the polarizing microscope and the relative
amounts of each constituent (biotite, quartz, and feldspar) determined approximately.
For this purpose, the following simple method was used: The sample of dust was
screened through *a 200-mesh screen, the product obtained was thoroughly mixed,
and a small amount was placed on a microscope slide and immersed in a liquid having
an index of refraction of 1.555. The dust particles higher and lower than 1.555 were
distinguished by the Becke line phenomenon and counted separately and the per­
centages of each calculated. Five fields were counted in this way and the average
taken. The same procedure was followed, using a liquid with index of refraction of
1.545. The volume percentages thus obtained were recalculated on the basis of the
specific gravities of the different constituents to give weight percentages. This
method was used on a portion of the sample analyzed by the tracing-paper method.
The results obtained by both methods were the same, although the counting method
in most cases is probably much less accurate than the tracing cloth pap£r method.
The counting method has the advantage of being much quicker and it probably has
sufficient accuracy for the purposes of this investigation.
In the microscopic examinations of the dusts the term ‘ ‘ very fine” is used to describe
particles having diameters of less than 10 microns (a micron being 0.001 millimeter or
about xrtnnr of an inch).
Seven rock-dust samples are described in detail and illustrated by micro-photo­
graphs of exceptional descriptive value. Briefly, the results may. be restated as
follows:
Sample No. 77971 shows 70 per cent of feldspar, 19 per cent of quartz, and 11 per
cent of biotite, etc. This sample reveals rather a small amount of very fine dust,
while fragments of 25 microns or larger were usually rounded. Smaller particles,
however, were found to have sharp, knife-like edges or sometimes needle-like slivers.
This sample is considered by the Bureau of Mines to represent one of the least harmful
samples of dust secured during the investigation.
Sample No. 77972 discloses 67 per cent of feldspar, 22 per cent of quartz, and 11
per cent of biotite, etc. Very fine particles were not common in this sample, while
other particles were usually rounded, although sharp, knife-like particles were present.
Particles of feldspar and mica were usually rounded; while a large flake of dark-colored
biotite and a smaller, well-defined cleavage fragment of feldspar were visible in the
micro-photographic figure. This sample also represents, in the judgment of the
Bureau of Mines, one of the least harmful samples of dust secured through the inves­
tigation.
In sample No. 77973 the proportion of feldspar was 65 per cent, of quartz 21 per cent,
and of biotite, etc., 14 per cent. In this sample a large amount of very fine dust was
present and decidedly more so than in the two preceding samples. There were also
a number of sharp, needle-like particles. This sample, according to the Bureau of
Mines, represents one of the most harmful types of dust, corresponding to sample
77976, to be described later.
Sample No. 77974 contains 67 per cent of feldspar, 18 per cent of quartz, and 15
per cent of biotite, etc. The proportion of very fine dust in this sample was rather
high, but, apparently, not so high as in sample 77973 and 77976. Fine needle-like
particles were abundant in this sample.
Sample No. 77975, representing air-floated dust derived from a beam near the roof,
contains 63 per cent of feldspar, 22 per cent of quartz, and 15 per cent of biotite, etc.
The percentage of very fine dust was fairly high, wiiile needle-like particles and par­
ticles with sharp angles were found very abundant, expecially in very fine material.
Sample No. 77976 contained 59 per cent of feldspar, 28 per cent of quartz, and 13
per cent of biotite, etc. This sample also contained a. very high percentage of very
fine dust, corresponding to sample 77973, while sharp needle-like particles were found
fairly abundant.




APPENDIX E.

147

Sample No. 77977 contained 68 per cent of feldspar, 20 per cent of quartz, and 12
per cent of biotite. It was also found to contain a fairly high percentage of very fine
dust, while sharp needle-like particles were very abundant.
The conclusions concerning this preliminary investigation are summarized by Dr.
Insley as follows:
Of the dust samples described in the preceding pages, those numbered 77973 and
77976 contain very large amounts of very fine dust. Sample No. 77973 was taken
from a rafter. Dust that lodged there must have been fine enough to remain in sus­
pension in the air for long periods of time and to be easily carried and lifted by air
currents. The fineness of sample No. 77976 was probably due to the type of machine
that created the dust.
It was thought before completing the mineral analyses that the fineness of the dust
and the place from which the dust sample was taken, such as beams near the roof,
might make considerable difference in the composition of the dust. However, the
analyses as given show only small variations and these variations may be in part due
to errors in analyses and sampling. Whatever difference in composition is due to air
separation of the dust constituents is so slight that il has no effect on the harmfulness
of the dusts.
Silicosis, or miner’s phthisis, is caused by the abrasion of lung tissue by fine particles
of hard, insoluble dust. The properties of rock dusts that make them injurious to
lung tissue are not exactly known, but it is generally agreed that the harmfulness
defends to a great extent upon the following properties: Hardness of the minerals of
which the dust is composed, solubility of the minerals in the fluids of the lungs, shape
and size of dust particles. Particles less than 10 microns in diameter and more than
1 micron in diameter are thought to be more harmful than other sizes. Sharp particles
with jagged edges or thin sliverlike particles are probably more injurious than particles
with blunt edges.
Of the minerals occurring in Barre granite, only biotite, feldspar, and quartz are
present in large enough quantities to be considered as possible causes of miner’s
phthisis. Biotite is probably the least harmful of the three predominant mineral
constituents, since its hardness on Moh’s scale is only 2.5-3, and the particles of
biotite observed in the dust samples usually had rounded edges. Feldspar is probably
much more harmful than biotite, since its hardness is from 6 to 6.5, and small, sliver­
like cleavage fragments are often present in the fine dusts. Quartz has a hardness of
7, and grains of this mineral seem to have a greater tendency to break up into particles
with long, sharp edges than grains of biotite or feldspar. Quartz is probably the most
injurious of any of the constituents of the Barre granite, but, because of the greater
quantity of feldspar present, the latter mineral may play a greater part as a cause
of miner’s phthisis than quartz.
Particles of steel from the drills and cutting tools used in the stone-cutting plants
have sometimes been considered the chief cause of miner’s phthisis at Barre. Steel
particles were not definitely identified in any of the dust samples from Barre. If
present they must occur in such small quantities as to be negligible as a cause for
miner’s phthisis.
According to Dr. Insley, if the relative amount of very fine dust in a dust sample
is an indication of the harmfulness of that dust, then the samples No. 77973 and No.
77976 should be the most harmful, while those numbered 77971 and 77972 should be
the least harmful.
The results of this in\ estigation should prove of far-reaching value to those concerned
with problems of dust phthisis in the mineral and related industries. They are, as
far as known, the first strictly scientific contribution to the study of the problem of
dust phthisis in American industry. The results are amplified by a preliminary
manuscript report on “ Rock-Dust Samples from the Stone-Cutting Plants of Aber­
deen, Scotland,” kindly provided by Dr. Matthew Hay, the medical officer of health,
in the furtherance of the present investigation. The report by Dr. Insley upon these
samples is as follows:
The following report is based on the microscopic and petrographic examination of
10 samples of rock dust from the stone-cutting plants of Aberdeen, Scotland, sub­
mitted to the Bureau of Mines by Dr. Frederick L. Hoffman, of the Prudential Insur­
ance Co., and obtained originally from Dr. Matthew Hay, the medical officer of health
of the Public Health Department at Aberdeen.




148

DUST PHTH ISIS IN THE GRANITE-STONE INDUSTRY.

For several samples the report is rather indecisive, du6 to the following causes:
No hand samples of the rocks from which the dusts originated were submitted, and
as the dusts were often quite fine certain minerals could not be definitely determined.
Most of the minerals were determined solely on their approximate indices of refrac­
tion. No data as to the nature of the rocks from which the dusts originated accom­
panied the samples.
The mineralogical composition given for each sample is only approximate and may
be in error by as much as 5 to 10 per cent. The following method was used to deter­
mine the mineralogical composition.^ A portion of the sample was screened through
a 200-mesh screen, with screen openings of 0.074 millimeters, and the material thus
obtained was examined under the petrographic microscope after being immersed in
a liquid of known index of refraction. By the Becke line effect, mineral particles of
higher refraction than the liquid could be distinguished from those of lower refraction
than the liquid. ^ The grains of each mineral present were counted and the per­
centage composition was based on this count. Where more than two minerals were
present in quantities greater than 5 per cent, another analysis was made, using a
liquid of different index of refraction. Thus, if quartz, orthoclase, and biotite were
present, a liquid with a refractive index of 1.555 was used to distinguish the biotite
from the quartz and orthoclase, and a liquid with index of 1.535 to distinguish the
orthoclase from the quartz and biotite. Error may be present due to the fact that one
mineral may crush inner than another. In every analysis three fields were counted
and the average taken.
Considered in the order of their numerical arrangement, these samples show the
following results:
Sample No. 1, marked “ Emerald Pearl-Norway,” shows 67 per cent of feldspar,
15 per cent of biotite, 13 per cent of quartz, and 5 per cent of opaque minerals.
Opaque minerals were not determined. The particles were found generally large
with very few under 10 microns, while few sharp particles were noted.
Sample No. 2, marked “ Bonnacord Black-Sweden,” shows 62 per cent of feldspar,
33 per cent of olivine (?), and 5 per cent of biotite. The particles were large, few
were smaller than 10 microns, and there were only a few particles with sharp edges.
Sample No. 3, marked “ Sclattie-Aberdeenshire,” contained 53 per cent of feldspar,
27 per cent of quartz, 15 per cent of biotite, and 5 per cent of opaque minerals. This
sample contained a large percentage of very fine material, or of less than 10 microns
in diameter while also containing a large number of fine slivers and particles with
sharp edges.
Sample No. 4, marked “ Rubislaw-Aberdeenshire, ’ ’ contained 65 per cent of feldspar,
23 per cent of quartz, and 12 per cent of biotite. The fineness and shape of the par­
ticles in this sample were about the same as in sample No. 3.
Sample No. 5, marked “ Peterhead-Aberdeen,’ ’ contained 80 per cent of feldspar,
10 per cent of quartz, 5 per cent of hornblende (?) and 5 per cent of opaque minerals.
A large number of very fine particles were present in this sample and sharp knife-like
particles were numerous.
Sample No. 6, marked “ Balmoral Red-Sweden,’ * contained 77 per cent of feldspar,
12 per cent of biotite, and 11 per cent of quartz. Sharp knife-like particles and thin
slivers were fairly abundant.
Sample No. 7, marked “ Glencoe-Finland,” contained 51 per cent of feldspar,
35 per cent of quartz, and 14 per cent of biotite. This sample contained a large
number of very fine particles, many of which had sharp edges.
Sample No. 8, marked “ Green-Sweden,’ ’ contained 75 per cent of feldspar and
25 per cent of augite (?) and biotite. In this sample a very large number of fine
particles were present.
Sample No. 9, marked “ Kemnay-Aberdeenshire,” contained 69 per cent of feldspar,
20 per cent of quartz, 6 per cent of biotite, and 5 per cent of opaque. Very fine
particles and particles with sharp edges were not abundant.
Sample No. 10, marked “ Rubislaw-Aberdeen,” contained 63 per cent of feldspar,
29 per cent of quartz, and 8 per cent of biotite. A rather large quantity of very fine
dust was present, with an abundance of sharp sliverlike particles.




APPENDIX F.

149

As intimated in the report, the Aberdeen samples were probably not sufficient for
strictly comparable conelusions with the data derived from the Barre granite-cutting
shops, but they afford for the first time a thoroughly trustworthy basis of comparison
between the underlying factors responsible for phthisis in the granite-cutting industry
of Aberdeen and the corresponding labor conditions in the granite-cutting industry
of the Barre district. Both series of samples justify the suggestion that further
research in this direction through the Bureau of Mines would, unquestionably, yield
results of far-reaching importance to medical science and industrial betterment.

APPENDIX F.— STONE WORKERS’ MORTALITY, ABERDEEN, SCOTLAND.
Since this paper was prepared the following material bearing upon the health con­
ditions in the stone industry of Aberdeen has been received from Dr. Matthew Hay,
medical officer of health, with the information brought down to the end of the year
1920. The letter transmitting the tabular data states in part as follows:
I am afraid that, although the information now sent is as reliable as we can make
it from the material available, it may not be very satisfactory for the purposes of
comparison between the last 10 years and the preceding 10 years, due chiefly to the
war having covered part of the later period. The war carried into its service men
from all kinds of occupations, including stonecutters and masons. The number of
stonecutters and masons in employment during the years of the war was only about
a half to two-thirds what it was during the five years before the war. Thus the number
of stonecutters and masons at work in 1910 was about 1,590 and remained much the
same until 1914. In 1915 it fell to about 1,070 and went on decreasing until 1918,
when the number was about 510. Since 1918 it has been gradually increasing, but
is still considerably short of the numbers before the war.
It will be seen from the table now sent you that there was an absolute increase of
deaths from phthisis during the years 1914 to 1917, inclusive. In four of the years
dealt with in Table 1 we know of one or two of the men who died from phthisis having
been in the army, and whose death may, therefore, have been due to the severities
of army service; but it is difficult to get full information regarding this point, as we
have dealt only with those who died in Aberdeen or in Scotland, and whose deaths
were transferred to us by the registrar general. Deaths abroad or in England were
not included, and were not reported to us, and accordingly we have no means of
knowing of them.
You will observe that the death rate from phthisis in the five years preceding the
war, including the year 1914, toward the end of which the war began, was 5.4, as
against 5.7 for the preceding 10 years. In the five years following 1914 the death
rate averaged 13.7.
I need not say that it would be altogether wrong to attribute this higher death rate
recently to any change in the conditions of occupation among stonecutters in the city.
These conditions have remained practically unaltered from what they were during
the years immediately preceding the war.
I send you also a table giving the total number of deaths from tuberculosis, and
certain other diseases for the different occupations dealt with in my report of 1910,
the figures now given being for the whole period 1910-1919. The corresponding
figures for the period 1900-1909 are also given, having been extracted from the special
report of 1910.
It will be noted that the percentage of deaths from pulmonary tuberculosis in deaths
from all causes has, during the later decennium, declined slightly, as compared with
the earlier decennium, but the decline is not so great as in certain other trades in
which the tuberculosis death rate was found in the early decennium to be high—
notably printers and clerks.
It may also interest you to have the inclosed table (Table 3) giving the average age
at death of stonecutters and masons for each of the years from 1910 to 1919, in order
to show whether the age rose during the war, owing to the absence of the younger men
on military and naval service. The effect was not very pronounced, as you will see,
in respect of phthisis. It is more obvious in regard to deaths from circulatory and
nervous diseases.
I
inclose, further, a table (Table 5) giving you the death rate from pulmonary
tuberculosis among males and among females in the whole city during 11 years 1910-




150

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

1920. It is interesting to observe how the death rate rose much more among women
than among men. I think this must have been due mainly to anxieties of the war
in those who remained at home. I am inclined to think that,#although there was
restriction in the supply of certain articles offood, it was rather in respect of the less
essential articles, and we had no evidence in the city of anything approaching to
starvation. Food, of course, became dearer as the war went on, but wages also rose
correspondingly. The allowances to the wives and children of the men who went to
the war were, in the later part of the war at least, fairly substantial.
You asked for samples of granite dust in your letter. I am sending you under sepa­
rate cover samples of dust from 10 different kinds of granite as used in Aberdeen for
the making of monuments. Five of the samples are of foreign granites, which are used
to a considerable extent in Aberdeen for monuments. The others are from Aberdeen­
shire. They were all obtained from the monumental granite yards and represent
the dust as collected in the sheds while the men were carrying on their work.
The results of this investigation are a notable contribution to the scientific study
of the problem of dust phthisis in the stone industry. The tables emphasize the
statistical methods most likely to yield reasonably trustworthy results, and further
improvements in statistical technique would unquestionably be advisable. Until
factory inspection departments secure the necessary powers to install health registers
for all employees in dangerous trades, amplified by powers to make preliminary
physical examinations of applicants for work and periodical physical examinations
subsequent to commencement of work, such data as the preceding must needs serve
as a tentative basis for conclusions which affect the present and future welfare of a
considerable portion of men employed in gainful occupations wherever industries
are carried on.
1.— NUM BER OF DEATHS AND D E A T H RATES OF STONECUTTERS AND MASONS
IN A B ER D EEN , SCOTLAND, FROM PULM O NAR Y TUBERCULOSIS AND O TH ER CAUSES,
1910-1919.

T a b le

Number of deaths.

Deaths per 1,000 persons employed.

Pulmo­
nary
tubercu­
losis.

Lung disoases?ex­
cluding
pulmo­
nary
tubercu­
losis.

Circula­
tory and
nervous
diseases.

1910...............................
1911...............................
1912...............................
1913...............................
1914...............................
1915...............................
1916...............................
1917...............................
1918...............................
1919...............................

9
7
5
9
10
12
m
U4
28
19

4
3
3
4
6
4
3
3
6
4

8
13
8
13
10
18
7
11
12
6

29
36
29
34
33
42
30
38
36
23

5.7
4.8
3.5
6.3
6.4
11.2
13.5
22.7
15.8
9.6

' 2.5
2.1
2.1
, 2.8
3.8
3.7
3.7
4.8
11.8
4.3

5.0
9.0
5.6
9.1
6.4
16.8
8.6
17. 8
23.7
6.4

18.3
24.8
20.2
23.8
21.1
39.3
36.7
61.6
71.0
24.4

Total..................
1910-1914......................
1915-1919......................

94

40

106

330

8.2
5. 4
13. 7

3.5

9.3

28.9

1920...............................

4

3

7

25

.4.0

2.9

6.9

24.6

Year.

All
causes.

Pulmo­
nary
tubercu­
losis.

Lung dis­
eases, ex­
cluding
pulmo­
nary
tubercu­
losis.

Circula­
tory and
nervous
diseases.

All
causes.

1 Including 1 known to be in Army, similar inquiry not made regarding deaths from other causes.
2 Including 2 known to be in Army, similar inquiry, not made regarding deaths from other causes.




APPENDIX F.

151

T a b le 2,—NUM BER OF D E A T H S OF W O R K E R S IN A B E R D E E N , SCOTLAND, AN D PRO­
PORTION D Y IN G FROM P U L M O N A R Y TUBERCULOSIS, 1900-1909 A N D 1910-1919, B Y
OCCUPATIONS.

1900-1909

1910-1919

Number of
deaths.
Occupation.

Total number of deaths.

Per
cent of
Lung
deaths
dis­
from
Circu­
eases,
Pulmo­ pulmo­ Pulmo­ exclud­ latory Other
All
nary
nary
nary
and
ing
dis­
causes. tuber­ tuber­ tuber­ pulmo­ nerv­
culosis. culosis. culosis. nary ous dis­ eases.
tuber­ eases.
culosis.

Per
cent of
deaths
from
pulmo­
All
nary
causes. tuber­
culosis.

Males.
Stonecutters and masons___
Stone polishers and sawyers.
Joiners, shipwrights, etc........
Painters.............1.....................
Tailors.......................................
Bakers.......................................
Engineers, blacksmiths, etc..
Printers and lithographers...
Comb makers..........................
Carters.......................................
Laborers....................................
Clerks.........................................

316
76
295
87
164
74
367
52
78
177
935
178

99
11
26
9
20
5
47
17
15
16
81
46

31
14
9
10
12
7
13
33
19
9
9
26

94
9
19
4
14
5
36
8
10
16
118
41

40
15
29
6
11
13
80
3
15
32
179
13

106
21
108
27
42
37
222
16
33
71
415
74

90
30
131
38
50
28
261
22
37
96
486
74

330
75
287
75
117
83
599
49
95
215
1,198
202

28
12
7
5
12
6
6
16
11
7
10
20

164
738

34
74

21
10

28
63

18
93

47
283

69
391

162
830

17
8

Females.
Dressmakers and milliners...
Domestic servants...................

T able

3.—AVER AGE AGE AT D EATH OF STONECUTTERS AND MASONS OF AB E R D E E N ,
SCOTLAND, B Y Y E A R S, 1910 TO 1919.

Year.

Phthisis.

Lung dis­ Circulatory
eases,
and
excluding
nervous
phthisis.
diseases.

Other
causes.

All causes.

1910......................................................................
1911.......................................................................
1912......................................................................
1913......................................................................
1914......................................................................
1915......................................................................
1916......................................................................
1917......................................................................
1918......................................................................
1919......................................................................

43
52
44
45
48
47
47
52
46
50

59
59
59
60
59
58
54
59
65
71

52
57
62
61
66
66
63
66
60
67

55
59
61
56
52
56
54
56
62
42

51
57
58
56
56
58
53
58
58
57

Average (years)......................................

48

61

62

57

56




152

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

T abue 4 .—AVERAGE. AGE AT D E A T H OF W O R K E R S IN A B E R D E E N , SCOTLAND, D Y IN G
FROM PU LM O N AR Y TUBERCULOSIS AN D A L L CAUSES, 1900-1909 A N D 1910-l«49r B Y
OCCUPATIONS.
Average age at death of workers dying in—
1910-1919

1900-1909
Occupation.
All
causes.

Pul­
monary
tuber­
culosis.

Pul­
monary
tuber­
culosis.

Lung
diseases, Circula­
exclud­ tory and
ing pul­ nervous
dis­
monary
eases.
tuber; culosis.

Other
diseases.

All
causes.

Males.
Stonecutters and masons............
Stone polishers and sawyers.......
Joiners, shipwrights, etc.............
Painters................. ........... , ..........
Tailors.............................................
Bakers.............................................
Engineers,, blacksmiths, etc........
Printers aad lithographers,........
Comb makers.................................
Carters............... .............................
Laborers.........................................
Clerks.................................... .........

51
54
60
51
59
56
55
48
57
54 ;
59
47 ;

43
43
36
30
41
39
38
33
47
38
41
3&

48
48
39
36
41
&7
45
34
47
48
42
32

61
53
68
63
53
62
57
53
57
54
59
51

62
64
66
60
62
62
61
55
61
61
62
57

57
63
64
54
65
60
56
54
58
53
60
60

56
61
64
m
60
60
57
m
58
55
58
53

52
62

29
34

34
39

75
66

60
65

55
6a

55
62

Females.
Dressmakers and milliners.........
D omestic serv ants........................

T able 5 .—D E A T H R ATES FROM P U L M O N A R Y TUBERCULOSIS IN A B E R D E E N , SCOT­
LA N D , B Y Y E A R S , 1910 TO 1920.
Deaths per 100,000 of
population.

Deaths per 100,000 of
population.
Year.

Year.
Males.

1910
1911
1912
1913
1914
1915




112

137
104
126
124
133

Fe­
males.

Both
sexes.

no

in

98
87
87
87
132

11%
95

105
104
133

Males.

1916.
1917
1918
1919
1920

108
129
103
91
75

Fe-

117
100
110
79
112

Both
sexes.
113
113
107
84
95

APPENDIX a.
APPENDIX

i& a

G.— REPORT OF MEDICAL INVESTIGATION
CUTTERS OF BARRE, VERMONT.

C o m m it t e e

on

the

M o r t a l it y

prom

T

u b e r c u l o s is

in

OF

GRANITE

D usty T r ad es.

REPORT OP TH E CHAIRM AN OF THE MEDICAL INVESTIGATION OP THE GRANITE CUTTERS
OP B A R R E , VE R M O N T.

To the Executive Committee of the National Tuberculosis Association.
G e n t l e m e n : The following summary report presents the conclusions reached from
the medical examination made during the past 13- months of approximately 475 men
employed in the granite industry at the city of Barre, Vt.
It forms a continuation of and a supplement to the statistical investigation reported
to the executive committee by Dr. Frederick L. Hoffman, chairman of the special
committee on dusty trades, in April, 1920.
As indicated, in the report of Dr. Hoffman,, the difficulties of carrying out an ade­
quate physical and X-ray examination of the men at the city of Barre were considerable.
But for the enthusiastic and generous help from one of the local physicians in Barre*
Dr* D. C. Jarvisr who was able to carry out the X-ray examinations with his own
equipment and technicians, the expense would have been very great. In order to
make it possible he was obliged to add some apparatus at his own expense, besides
giving fully of his time and means to perfecting the. technique of chest examinations
for stereoscopic view. It is fair to state that without his aid the investigation would
not have been possible or the quality of the; X-ray negatives of such excellence.
The physical examinations were made for the most part by Dr, John H. Woodruff
and Dr. Roscoe E, Avery, local physicians, who also gave their services gratuitiously
and who were most intelligent and efficient in their wo»k. A series of clinics was
arranged to accommodate the men after working hours and on Sundays. The services
of Dr. Edward J. Rogers, medical director of the Vermont State Sanatorium, and of
Dr. Henry A. Ladd, State tuberculosis consultant, were also secured for several of the
clinics; also ©I Dr. P. Challis Bartlett* chief medical examiner of the Framingham
Demonstration, who held two sessions, and of Dr. Morgan, of the Metropolitan Sana­
torium at Mount McGregor, N. Y . To all of these gentlemen, as well as to the office
staff of Dr. Jarvis, I desire to make due acknowledgment of our cordial appreciation.
During all of the clinics at which the visiting consultants were present, two of which
were held by your chairman, the more obscure cases, in which the diagnosis of tuber­
culosis was difficult, were examined.
The ready and helpful cooperation of the secretary of the Vermont State Board of
HeaJkth, Dr. Charles F. Dalton, and the Vermont Tuberculosis Association was also
obtained.
The Barre Granite Cutters’ Association gladly cooperated and contributed an assess­
ment toward the expenses, as stated in a previous report by Dr. Hoffman.
The Granite Manufacturers’ Association was favorably disposed toward the investi­
gation when its object was fully understood, and undoubtedly would have contributed
collectively toward the expense but for a prolonged strike which was inaugurated
simultaneously with the start ©f the physical examination clinics. This untoward
incident seriously hampered the survey, though at first many men were willing to
undergo examination because they were idle. Later,, as the strike continued, more
than 500' left the city,, many of whom have not returned since the resumption of the
work in the fall of 1920.
The number originally recorded in the inquiry conducted by Mr. Sylvester Schattschneider was 1,085. Of this number 235 were also subjected to a physical and X-ray
examination. The remainder, comprising nearly half of those examined, had not
been reached In the preliminary survey. The number who were usually regarded
as migratory ranged from 8 to 10 per cent. Twelve have died during the investiga­




154

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

tion. Thus a statement of the physical findings can be made concerning only onefourth of the original number surveyed.
Nevertheless, it is a satisfaction to report upon a sufficiently large number to reveal
the serious effects on men who had undergone long exposure to granite dust. It
must be borne in mind that it was natural to expect the men who were suffering from
ill health to seek examination. The figures, therefore, can not be taken literally to
apply to the total number of men employed, when percentages are considered; they
apply only to the men who were examined. It was indeed found difficult to induce
as many as were desired of the men in apparent health to undergo the examinations.
Nevertheless ultimately, through the persistent efforts of the Granite Cutters’ Asso­
ciation, many such were examined.
The primary object in each case was the discovery of tuberculosis, whether or not
complicated by silicosis. 1 The history of all illnesses was taken, family or household
exposure to tuberculosis, and period of employment as a stone cutter. Much other
data was collected, which can not be considered in a brief report. In a large number
the examination included the nose and throat as well as the chest. Stereoscopic
films were made in most cases and by a uniform technique, made possible by the
use of modern methods. The faulty negatives were due in the main to inability of
the men to understand the directions and to nervousness.
In the reading of films I have had the helpful assistance and criticisms of the
Trudeau Sanatorium staff, especially of Mr. Homer L. Sampson, the resident roentgeneologist, who studied the entire collection. The X-ray findings were recorded
without referring to the history notes, and hence are unbiased by knowledge of the
physical examination or sputum findings.
After all the data had been entered on the history blanks (see p. 158) they were sub­
mitted to Miss Jessamine S’. Whitney, statistician of the National Tuberculosis Asso­
ciation, who has been most helpful in arranging the accompanying tables and in sug­
gesting the best use of the material.
A total of 427 men have been examined by both X-ray and physical methods.
Records of the physical examinations were omitted on the history charts in 31 cases.
There were in addition 48 examinations by the X-ray not included in the tables, as
the histories were imperfect or wanting. In 69 cases (16 per cent) the X-ray films
were imperfect or blurred.
It was soon discovered that remarkably extensive silicosis might exist with little
or no impairment of health and no manifest physical signs. On the other hand, after
a tabulation of those cases found to be tuberculous by a sputum examination, there
were physical signs recorded in 19 out of 26 (see Table 1 ). likewise, in the men
who showed a definitely tuberculous shadow by X-ray examination, 14 out of 31
revealed chest signs. Among those exhibiting in the X-ray films silicosis alone,
without suspicion of a complicating tuberculosis, only 14 per cent had any physical
signs. There were 56 in whom tuberculosis was suspected by X-ray examination,
in 27 of whom physical signs were recorded.
In the suspected class there were a number of X-ray films in which tuberculosis
and silicosis were indistinguishable. The latter obtained chiefly in advanced silicosis
with much density in the chest films. The material has been studied and tabulated
according to the usual three stages of tuberculosis as adopted by the National Tubercu­
losis Association, or the Turban standard, but only on the basis of the radiographic
appearances. Likewise, three stages of silicosis were recorded in conformity with
the standards used in the studies of the South African Miners’ Phthisis Prevention
Committee2 and those of Lanza and Childs in their study of the zinc miners of
Missouri.3
1 This term is used because silica has been found to be the principal ingredient of granite, as of other
forms of quartz stone.
2 General Report of the Miners' Phthisis Prevention Committee, Pretoria, 1916.
a Miners’ Consumption, etc., by A . J. Lanza and S. B. Childs, U .S . Public Health Bulletin No. 85, Janu­
ary, 1917.




APPENDIX G.

155

The South African committee was able to correlate the radiographic appearances
with the pathological findings in silicosis with and without complicating tuberculosis
in 26 fatal cases. The opportunity for post-mortem examinations in Barre were not
frequent, and but one was secured during the investigation and this one a tuberculous
silicotic case from an outside institution not included in the tables. The general
impression obtained of the relatively small number examined in our study completely
supports the inestimable importance of a technically good radiogram, especially a
stereogram, in detecting silicosis in its early and late stages. It is also capable of
differentiating by skilled interpretation between simple silicosis and a complicating
tuberculosis. To quote the last report 4 of the Miners’ Phthisis Board:
“ It is the unanimous opinion of the bureau that a technically satisfactory radio­
gram is of paramount importance in assisting in the formation of a just decision as to
the presence or absence of silicosis. It is also of the greatest utility in the diagnosis
of all but the very earliest cases of tuberculosis. Our experience has, however, con­
firmed the suspicion that unless the X-ray negative reaches a well-defined standard of
technical excellence its interpretation may be erroneous.”
I have quoted this paragraph because of its practical importance in the valuation of
our observations.
In the present report the details concerning the effect of granite dust inhalation and
the method of determining silicosis and its complications must be omitted. The
description given by Childs from the examination of 1 0 0 radiograms of the zinc miners,
and the South African reports above mentioned, are very complete and can be referred
to if desired. A later report dealing with the medical data will be submitted when the
histories have been completed. A proposition to make successive radiograms of the
men already reported upon is being considered by the Barre representatives as a
logical outcome of the investigation.
Analysis of results as tabulated.— It is only necessary to glance at the tables to dis­
cover, not only an extensive amount of silicosis, but also a very considerable number
complicated with tuberculosis. Besides, there are an equal number of suspected
tuberculosis cases, making altogether one-fourth of the men examined. It must be
remembered that, except for the open tuberculosis cases with the presence of bacilli
in the sputum, who were in most instances incapacitated, the majority were at strenu­
ous work and no prediction is at present justified as to the ultimate results to them of
the dormant tuberculosis infection. It is significant that physical signs were found
in one-half of those suspected of tuberculosis, and they comprised most of those classed
in the third stage of silicosis. On the other hand, the physical signs were seldom so
clear as to be alone conclusive in the diagnosis of tuberculosis. Sputum examina­
tions were sought for in all cases, but it was a difficult matter to obtain specimens.
When present it was most often mucoid except in a few late stage cases of tuberculosis.
Table 1 shows the result of the interpretation of the radiograms.
Table 2 gives the average time of exposure to dust.
Table 3 summarizes the symptoms. It exhibits the inadequacy of histories taken
of men who consider themselves well. But few admitted any symptoms except when
Suffering from advanced silicosis with or without tuberculosis.
Table 4 relates the time of exposure to dust and the stages of silicosis. Note should
be made of the fact that prolonged exposure is not necessarily followed by silicosis or
tuberculosis.
Table 5 sets forth the relation of race to stages of silicosis. It was noted early in
the radiograms that Italians commonly escaped the severe forms of silicosis, the per­
centage of third-stage cases being one-half that of other races. No explanation is at
present obvious, though it was noted that the Italians have come more recently to the
<Annual Report

of th e Miners' Phthisis Board, etc., Capetown, 1920, p. 35.

61928°— 22— Bull. 293-------11




156

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

Barre district than the Scotch, lor example, and many had been engaged in marble
cutting elsewhere.
Conclusions.— While the histories and examinations were incomplete and to some
extent imperfect, the stereoradiograms of 475 granite cutters of the city of Barre, Vt.,
were of unquestionable value.
The disclosure of high percentages both of silicosis and tuberculosis in the men
examined concerns these men alone. Nevertheless it must be admitted that similar
results must be expected for a certain proportion of men engaged for 1 0 or more years
in this trade.
The preliminary statistical inquiry covering the mortality from tuberculosis in the
granite industry of Barre, Vt., revealed an increasing rate, according to the report
submitted by the chairman, Dr. F. L. Hoffman.
The medical and X-ray examination has furnished confirmation of the correctness
of the diagnoses, for the most part, of tuberculosis complicating advanced silicosis
when such has been made on death certificates in the absence of a positive sputum. 6
Whether the high incidence of tuberculosis has any close relation to family infection
in this group was not clearly brought out from the histories. Healed and calcified
tubercles were noted in 1 0 .8 per cent of the X-ray films, exclusive of those adjudged
tuberculous because of more extensive lesions or actual clinical disease.
The fact that tuberculosis apparently supervenes on an extensive silicosis, usually
after 10 to 15 years’ exposure, suggests the marked predisposing influence of granite
dust (as of all quartz dust), whether from recent or old infection.
Finally, it is gratifying to report that this investigation has stimulated experiment
tation with dust-removing devices especially adapted to the pneumatic cutting
process. Through the efforts of Dr. D. C. Jarvis, with the assistance of one of the
manufacturers in Barre, a large measure of success has already been attained in the
perfection of a practical aspirator. Coincident with the general adoption of dust
removers it is to be hoped and recommended that wherever granite cutting is carried
on facilities should be provided for careful physical examinations and periodical
radiograms of the chest by a skilled and uniform technique.
(Signed)
E d w a r d R. B a l d w i n , M. D.
S a r a n a c L a k e , N. Y ., June 11, 1921.
T

able

1 .—RESULTS OF X -R A Y A ND PHYSICAL EXAM IN A TIO N S OF 427 MEN EM PLOYED
IN T H E G R AN ITE IN D U ST R Y IN B A R R E , V T .

Classification of cases.

Con­
firmed
To­ by
tal. physi­
cal
signs.

All cases.......................................... 427
Clinical tuberculosis (tubercle
bacilli in sputum)..................... 26
Tuberculosis, definite, by X-ray
interpretation............................. 31
Tuberculosis, suspected, by
X-ray i nterpretation................. 56
Tuberculosis, infection (healed
calcified tubercles).................... 35
Silicosis, uncomplicated.............. 157
Silicosis, suspected, uncom-plicated........................................ 26
Unsatisfactory films..................... 69
Normal chests................................ 27
o No record, 1.

b No record, 2.

Tuberculosis
(Turban
Silicosis.
Con­
standard).
firmed
by
symp­
toms. Stage Stage Stage Stage Stage Stage Sus­
II.
III.
IL
III. pected. None.

97

113

34

28

7
7

198

75

44

82

«19

26

3

16

3

6

13

4

b 14

14

11

3

11

11

7

1

c27

23

18

9

25

11

18

2

d2
*21

7
41

2

21
119

8
33

1
5

5

b2
b 11
b1

2
19

6

c No record, 8.

a No record, 1.

26
44

28

1

*
27

* No record, 13.

5 From the Vermont State Board of Health it was ascertained that in 75.4 per cent of the deaths of such
cutters reported from Barre as tuberculous at death the sputum waa positive on the State Laboratory
records.




A P P E N D IX

Q.

157

T&bxje 2— A V E R A G E TIME OF E X P O SU R E TO G R AN IT E TO ST 0<F 42-7 I O N E M P LO Y E D
I K THE G R A N IT E IN D U S T R Y IN BARJRE, V T ., W H O W E R E G IVE N X -R A Y AN D
PHYSICAL E X A M IN A T IO N S.
Average time of exposure to dust
(in years).
Classification of cases.

Total
eases.

AH cases.................................................................... ................. .

427

23.7

19.2

25-5

29.7

18. 3

16.1

CHmical tuberculosis (tubercle bacilli in sputum).............
Tuberculosis, definite, by X-ray interpretation................
Tuberculosis, suspected, by X-ray interpretation............
Silieosas, uncomplicated (but including those showing
healed calcified tubercles).................. . .............................
Unsatisfactory films................................ ..............................
Normal chests...........................................................................

26
31
56

25.3
28.0
24.2

10.0
27.8
20.9

21.6
30.4
2S.7

29.5
28.4
29.7

38.0
0)
23.0

a 14.0

218
69
27

23.6

18.5
18.1

22.9
33.3

30-0

15.6
19.5

Silicosis.
Con­
firmed
by
symp­ Stage Stage Stage Sus­ None.
toms.
II.
III. pected-

16.2
1

1 Unknown (1 case).
Table

2 1 case.

3.— N UM BER OP B A R R E , V T ., G R AN ITE CUTTERS E X A M IN E D W H O H A D SPECI­
FIED SYMPTOMS, B Y STAGE OF SILICOSIS.

Silicosis.
Symptom.
Sus­ Stage Stage Stage
pected.
II.
III. None.
All cases.....................................................................................

82

198

75

44

Cough........................................................................................
Expectoration..........................................................................
Shortness of breath.................................................................
Loss of strength.....................................................................
Hemoptysis............. '.................................................. ...........
Loss of appetite......................................................................

3
5
6
1

18
33
19
4

1

5

11
18
15
10
2
1

14
15
19
11
2
5

T a b le 4 .—TIME

Per
cent.

Total.

28

427

100.0

1
2
2
1

46
72
61
28
5
12

10.8
16. 8
14.3
6. 5
1. 2
2.8

OF E X P O SU R E TO GR ANITE DUST OF 427 B A R R E , V T., GRANITE
CUTTERS AS R EL ATED TO STAGE OF SILICOSIS.
Silicosis.

Time of exposure to granite dust.

Suspected.

Stage I.

Stage II.

Total.
Stage III.

None.

Per No. Per No. Per
Per
Per
No. cent.
cent.
cent. No. cent. No. eent.
All cases......................................... .............. 82

19.2 198

Under 1 year................................................ 3
1 year and under 2 years...........................
2 to 4 years...................................................
3
5 to 9 years................................................... 13
10 to 14 years................................................ 14
IS to 19 years................................................ 9
20 to 24 years................................................ 14
25 to 29 years................................................ 8
30 to 40 years................................................ 9
Over 40 years............................................... 4
Unknown.....................................................
5

60. 0




33. 3
31. 0
22. 6
13.0
19.7
13.3
12.2
25.0
27.8

46.4

2 40. 0
1 100.0
3 33. 3
19 * 45.2
36 58.1
43 62. a
32 45.1
27 45.0
25 33.8
1 12.5
8 44.4

75

3
3
6
9
14
14
18
6
2

17.6

33. 3
7.1
9.7
13.0
19.8
23.3
24.3
37.5
11.1

44

1
3
6
8
20
4
2

10.3

28

Per
No. cent.

6.5 427

100.0

5
1
9
42
62
69
71
60
74
16
18

1.2
.2
2.2
9.8
14.5
1-6 .2
16.6
14.1
17.3
3.7
4.2

7 16.7
i. 6
5
8.1
7.2
4.3
5
8.5
5
7.0
13. 3
3
5.0
2
2.7
27.0
25.0
11.1 " i * " 5 .5

158

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

5 — R ELATIO N OF RACE TO SPECIFIED STAGES OF SILICOSIS AS SHOW N B Y
X -R A Y A N D PH YSICAL E X A M IN A T IO N OF 427 B A R R E , V T ., GRAN ITE CUTTERS,
CLASSIFIED B Y AG E.

T able

Age (years).
Nationality and stage of
silicosis.

Total.

Un­ 20 25 30 35 40 45 50 55 60 65 70
Un­
Per
der to to to to to to to to to to and
known. No. cent.
20. 24. 29. 34. 39. 44. 49. 54. 59. 64. 69. over.
60

42

20

35 22
3. 4
7
19
6
8
5
3
3
6
15 19 13
1
4
2
3
10 12
1
3
6
2
2
1 ....
1
3
7
5
1
1
2
'4'
"i*
1
1
1
3
1
17 13 14 13
3
2
4
4
9
8
3
9
3
4
3
1
2
1
1
1
2
3
5
1
1
1
2
1
2
1
2

14
5
6
2
1

5
1

10
2
4
1
3

7

1

1

3
4

1

1

All cases........................................

4

17

44

77

71

Italian...........................................
Suspected..............................
Stage I ....................................
Stage I I ..................................
Stage I I I ................................
None.......................................
Scotch............................................
Suspected..............................
Stage I ....................................
Stage I I ..................................
Stage I I I ................................
None.......................................
American.................. ...................
Suspected..............................
Stage I ....................................
Stage I I ..................................
Stage I I I ................................
None.......................................
Other nationalities......................
Suspected..............................
Stage I ................. - ............
Stage I I ..............................
Stage I I I ................................
N one.......................................
Unknown......................................
Suspected..............................
Stage I ...................................
Stage I I ..................................
Stage I I I ................................
None.......................................

1

11
5
4
1

17
8
7
1

41
g
21
6

1

1
4
1
2

36
6
22
5
1
2
17
2
12
2

1
1
1

1
1

1
2

3
2
1 "2

...J ....
3 19
1
2
1 10
2
1
1

6
2
1

75

1

3

2

1

1
1

2
2

3

1

1
2

1

4

1

4
2
4

2

1

5

4

1

1
2
2

1
1
2

1

10

2

11 427

100.0

2 186
43.6
2 43
23.1
86
46.2
32
17.2
12
6.5
13
7.0
2 90
21.1
13
14.4
1 44
48.9
18
20.0
11 * 12.2
1
4
4.4
6.1
26
4
15.4
11
42.2
3
11.5
7
26.9
1
3.8
1 95
22.2
16
16.8
1 48
50.5
14
14.7
9
9.5
8
8.4
7.0
6 30
6
20.0
3
9
30.0
1
8
26.7
1
5
16.6
1
2
6.7

HISTORY BLANK USED IN INVESTIGATION.
I ndividual H istory.
Plant
Serial No
Index No
Last name
First name
Sex
Nationality

Date
Street
Age
Time in United States

In Barre

School attended now (if child):
Place of business
Kind of work
Factory work at home
Total income
Habits: Alcohol
Tobacco
Patent med
Coffee
Narcotics
Sickness in past few years requiring M. D
Injuries
Operations
T. B .: Now
Suspected.
In past
M. D
Place of treatment: Home
Results
Nature of present illness, if any
Name of present M. D




1 9 ...
No
M. S. W .

Tea

When
Institution

159

APPENDIX G.
History of—
Exposure to T. B .: Infancy.
Scarlet fever
Pneumonia
Grippe
Malaria
“ Decline”
Whooping cough
Fainting spells
Bronchitis
Large glands

School.
“ Slow fever”
Typhoid
“ Fever”
“ Sore throat”
“ Colds ”
Chest injuries
“ Rheumatism
Blood spitting
Tonsilitis

Work............

Home...

“ Cough”
Tumors (breast)
Measles
Pleurisy
Adenoids
“ Run down”
Asthma
Diphtheria
Mumps
Any other diseases

Is menstruation regular:
Any special interests:
Remarks:
Name of investigator.
H ealth E xamination .
Usual weight...................................... Height.............................................................
Temperature.......... Pulse.......... Respiration.,........ Blood pressures. . S..
D ....
Cough.............................. Sh. of breath.............................. Hemoptysis.............
Expectoration.................... Loss of strength.................... Loss of appetite__
Pain in chest: Front upper half one side............................................................
Front upper half both sides........................................................
Back lower half one side.............................................................
Back lower half two sides............................................................
Front and back one side..............................................................
Front and back both sides..........................................................
Night sweats............................ Occasional............................ Frequent..............
Supra sternal pitting...................................... Blood count.....................................
Supra clavicular pitting................................ Urinalysis.........................................
Direction of clavicles outward..................... X-ray examination........................
Scapula R. Flat prominent abducted....... Sputum............................................
L . Flat prominent abducted........ Wasserman.......................................
Ant. post measurement caliper midway scapula.....................................................
Same lateral 7th rib in axilla........................................................................................
Girth of chest at nipples in inches at full expiration..............................................
Full inspiration................................................................................................................
Girth of chest from int. border of scapula to nipple R. side.................................
L. side.................................................................................................
Hours of employment...................... Bad posture...................... Fatigue..........
Ventilation....................................................... V acation...........................................
Sleep alone............................................. How much average..................................
Food: Breakfast..............................................
Dinner..................................................
Supper..................................................
How many sleep in same room....................
Do you sleep with windows open................
Examiner...................................................................




t$ 0

DUST PH TH ISIS IN TH E GRANITE-STONE INDUSTRY.
General E

x a m in a t io n .

General appearance: Healthy.................... Emaciated.................... Pale.......... .
Physical development: Robust.............. Good.............. Fair.............. Poor___
Mouth breather.................. Vaccinated within five years...........Corneal sears R ____ L ..
Corneal scar R ............................................................ L ..................................................
Vision: R ........ L ........ With glasses, R ........ L ........ Wears reading glasses,
Eyes: Congestion................ Conjunctivitis................ Other abnormalities____
Ears: Otorrhea—Acute....................... Chronic.......................... Breasts................
Nose and throat: Catarrh—Acute.............. Tonsils— Septic.............. Enlarged
Septum......................................................... Turbinates.................................................
Adenoid......................................................... Moustache.................................................
Hair in nose...................................................
Larynx...................................................
Teeth:

Tongue:
Unclean. Decayed. Missing. Artificial.
Badly coated.

Upper.
Lower.
Lungs:

Inspection— shape: Normal............ Flat.............. Barrel.............. Retractions..............
Unequal expansion.............................. Old empyema scar..................................
Percussion (locate findings): Dullness.............................. Flatness...................................
Other changes in resonance.
Auscultation (locate findings): Change in: Breath sounds..........................................
Voice or whisper.................. Rales: Persistent................ After cough.........
Sputum required...................... Result.
Heart:
Rate............ Regular............ Irregular............ Murmur............ Heard loudest
at...................... Transmitted to back...................... Arterial walls..........................
Apex beat: Displaced downward.................... Right.................... Left..................
Pressure: Systolic..................................... Diastolic......................................... ............
Enlarged glands:
Occip.............. Cerv.............. A x .............. Epitroch.............. Goiter................
Skin:
Impetigo................ Favus................ Pediculosis................ Ringworm.......... ..
Active nonpul. T. B.:
Spine.................... H ip.................... Knee.................... Elsewhere........................
Malformations:
Round shoulders.............. Kyphosis.............. Scoliosis.............. Lordosis.............
Anchylosis.................. Lameness.................. Other..................
Abdomen:
Flat.......... Distended.......... Tenderness.......... Spasm.......... Hernia............
Tumor...................... Other findings......................
Venereal:
Knee jerks............................ Rhomberg............................ Other..............................
Diagnosis:
Remarks:
Examiner.............................................................................




mi

APP&NDDC *G.
F a m il y R

ecord.

Health insurance.
Previous address.
Color. . ..................

Landlord....................................
Length, of residence in Barre.
Church............................. ........

Occupation
(school).
Name.

Age.

Birth-

In­

come*
Place. Kind.

Family, adults:
Children:
Relatives:
H elp:
Lodgers or boarders:




Nurse

Sus­
Now. pect.

In
past.

Other Cause
illness
of
now. death.

1Q2

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.
APPENDIX H.— GERMAN SICK-FUND EXPERIENCE.

Attention should be directed to an exceedingly important investigation into the
industrial hygiene of particular trades reported to the medical section of the Ministry
of the Interior of the Prussian Government by Dr. Karl Opitz, Berlin, 1919. This
report is an exceptionally convenient summary of German sick-fund experience,
amplified by data derived from the German Recruiting Service. Unfortunately,
only the rates or percentages are given, so that it is difficult to say whether the con­
clusions are strictly trustworthy on the basis of a sufficiency of numbers. Military
rejections on account of military unfitness on physical grounds represent 31.5 per
cent of all rejections, as against 37.5 per cent for stonecutters (Steinmetzen). More
pronounced, however, are the differences in the general sickness rate among members
of the Leipzig Communal Sick Fund, which was reported as 39.6 per cent for all
occupations, but as having been 69.6 per cent for quarrymen, 58.1 per cent for stone­
masons, and 52.7 per cent for stonecutters.
In the experience of the Frankfort Sick Fund the rate was 62.9 per cent for all occu­
pations and 58.8 per cent for stonecutters, but when only such sickness is considered
‘ as caused incapacity for work the rate for all occupations was 24.1 per cent, and for
stonecutters 32.8 per cent. The Leipzig experience differentiates ages 15 to 19 and
20 to 24, with the following results: At ages 15 to 19 the sickness rate for all occupations
was 37.3 per cent, but for stonecutters the rate was 54.2 per cent and for stonemasons
50.2 per cent. At ages 20 to 24 the rate for all occupations was 35.5 per cent as against
46.5 per cent for stonecutters and 44.6 per cent for stonemasons.
Diseases of the respiratory organs caused a rejection rate in the military recruiting
service of 2 per cent of all rejections for all occupations, and of 16.7 per cent for stone­
cutters. In the experience of the Leipzig Sick Fund the sickness rate from diseases
of the respiratory organs was 56.3 per 1,000 for all occupations as against 101.5 per
1 ,0 0 0 for stonecutters. In the experience of the Frankfort Sick Fund the sickness
rate for bronchitis was 75.8 per 1,000 for all occupations and 110.3 per 1,000 for stone­
cutters. On limiting the term to those who were incapacitated for work as a result
of bronchitis, the rate for all occupations was 29.8 per 1,000 as against 81.1 per 1,000
for stonecutters. Inflammation of the lungs in the experience of the Frankfort Sick
Fund caused a general sickness rate of 4.2 per 1,000 as against only 3.2 per 1,000for
stonecutters. In the experience of the Leipzig Sick Fund at ages 15 to 19 respiratory
diseases caused a sickness rate of 42.8 for all occupations as against 76 for stonesettersand 57.4 for stonecutters. At ages 20 to 24 the rate for all occupations was
50.7, for stonemasons 51.6, and for stonecutters 78.1.
These observations have reference to nontuberculous lung diseases. They clearly
indicate a decidedly higher liability to such diseases on the part of men employed
in the stone industry than on the part of workers in general.
Still more pronounced are the differences as regards a specific liability to pulmonary
tuberculosis. In the experience of the Frankfort Sick Fund the average rate for all
occupations was 3.3 per 1,000 members, but for stonecutters the tuberculosis sick­
ness rate was 9.7. In the experience of the Leipzig Sick Fund the tuberculosis sickness
rate for all occupations was 7.7 per 1,000, while for stonecutters it was 24.7, the highest
figure for any occupation on record. For stonemasons the sate was only 5.3. The
Leipzig figures for age periods confirm the observations elsewhere made that pulmonary
tuberculosis is comparatively rare at ages under 30. At ages 15 to 19 the pulmonary
sickness rate was 3.8 per 1,000 for all occupations, but only 2.6 per 1,000 for stone­
cutters, while at ages 20 to 24 the average rate was 7.3 as against only 1.6 for stone­
cutters.




APPENDIX I.

163

APPENDIX I.— LIST OF REFERENCES.
“ A study of pulmonary silicosis,” by E. L. Middleton, M. D., in Journal of Industrial
Hygiene, March, 1921.
Australia:
Inquiry into the Prevalence of Tuberculosis at Bendigo, by D. G. Robertson,
M. D., Quarantine Service, Commonwealth of Australia, Melbourne, 1920.
Report of an Investigation at Bendigo into the Prevalence, Nature, Causes, and
Prevention of Miners’ Phthisis, by Walter Summons, Melbourne, Australia,
1907.
Report of the Royal Commission on Miner’s Lung Disease, Perth, Western Aus­
tralia, 1912.
Report of the Royal Commissioner on Pulmonary Diseases Among Miners, Perth,
Western Australia, 1910.
Report on an Inquiry into the Prevalence of Tuberculosis at Bendigo, Service
Publication No. 19 of the Quarantine Service of the Commonwealth of
Australia.
Report on the Ventilation of the Bendigo Mines, by Walter Summons, Depart­
ment of Mines, Victoria, Australia, 1906.
Reports on Miner’s Phthisis and Pneumoconiosis, prepared for the New South
Wales Board of Trade, Sydney, 1919.
Cocks, Gerhard H. Experimental Studies of the Effect of Various Atmospheric
Conditions upon the Upper Respiratory Tract, American Laryngological Society,
1915.
Comparative Tests of Air Dustiness with the Dust Counter, Konimeter, and Sugar
Tube, by S. H. Katz and L. J. Trostel, Pittsburgh, Pa., July, 1921.
“ Compensation for phthisis in grinding industry,” in The Lancet, London, November
27, 1920.
“ Conjugal tuberculosis,” note in British Medical Journal, October 15, 1921, p. 54.
Cottrell, F. G. Problems in Smoke, Fume, and Dust Abatement, Smithsonian
Report for 1913, Washington, D. C., 1914.
Die Steinindustrie in Grossherzogtum Baden, von Regierungsrat Dr. Fohlisch Beilage
zum Jahresbericht des Grosh-Gewerbeaufsamts fur das Jahr 1912, Karlsruhe, 1913.
“ Direct inhalation of calcium in treatment of pulmonary tuberculosis,” note in Bulle­
tin of the Academy of Medicine, Paris, December 20, 1921.
Diseases of Occupation and Vocational Hygiene, by Kober and Hanson, Philadel­
phia, Pa., 1916.
“ Dust and phthisis,” in Journal of American Medical Association, May 15, 1920.
“ Dustin expired air,” by Dr. J. S. Owens, in The Lancet, London, March 5, 1921.
“ Dustin expired air,” by the London correspondent, in Journal of American Medi­
cal Association, April 11, 1921.
‘‘ Dust inhalation and tuberculosis,” in The Lancet, London, November 15, 1919,
p. 888.
“ Dust ventilation studies in metal mines,” by D. Harrington, in Scientific
American Monthly, February, 1921.
“ Gannister disease,’ ’ by C. L. Birmingham, in Journal of the Sanitary Institute,
Vol. X X I , London, 1900.
Great Britain:
Annual Report of the Chief Inspector of Factories and Workshops for the year
1912, London, 1913 (Cd. 6852), with table on the “ Mortality from pulmonary
tuberculosis in certain dusty industries in relation to free silica present in
the dust.”
Annual Reports of the Chief Inspector of Factories and Workshops for the years
1913-1919, London, 1914-1920 (Cd. 7491).




i

m

DUST PH TH ISIS IN THE efLAJTITE-STONE INDUSTRY.

Great Britain— ConcludedMinutes of Evidence Taken Before the Royal Commission on Metalliferous Mines
and Quarries, Vol. I (Cd. 7477), Vol. I l l (Cd. 7478), London, 1914.
Report by the Medical Officer of Health of Aberdeen, Scotland, Dr. Matthew
Hay, for the year 1909, with an appendix on tuberculosis in Aberdeen.
Report on the Prevalence of Phthisis among Quarry Workers and Miners, Derby­
shire County Council, by Dr. Sidney Barwise, Derby, England, 1913.
Report to the Secretary of State for the Home Department on the Health of
Cornish Miners, London, 1904 (Cd. 2091).
Second Report of the Royal Commission on Metalliferous Mines and Quarries,
London, 1914 (Cd. 7476).
Supplement of the 55th Annual Report of the Registrar General for England and
Wales, Part II, 1897.
Supplement of the 65th Report of the Registrar General for England and Wales,
Part II, 1908.
Hill, E. Vernon. “ Quantitative determination of air dust,” in Heating and Ventilat­
ing Magazine, June, 1917.
Hoffman, F. L. “ Dust as a factor in occupation mortality,” address before the
Medical Society of the County of New York, in Medical Examiner and General
Practitioner, New York, 1907.
------ £1Dust hazard to health in the stone industry, ’ ’ in Proceedings of Seventh
Annual Safety Council, National Safety Council, September, 1918.
— — First Preliminary Report on the Mortality from Tuberculosis in Dusty Trades,
National Tuberculosis Association, 1918.
— — Influence of Trades on Disease, report to the Ninth Conference of Sanitary
Officers of the State of New York, 1909.
------ “ Legal protection from injurious dust,” in American Legislation Review,
American Association for Labor Legislation, June, 1911.
------ Menace of Dusts, Gases and Fumes, Bulletin of Pennsylvania Department of
Labor, 1918.
------ Mortality from Consumption in Certain Occupations Exposed to Municipal
and General Organic Dust, Bulletin No. 82, United States Bureau of Labor Statis­
tics, May, 1909.
------ Mortality from Consumption in Dusty Trades, Bulletin No. 79, United States
Bureau of Labor Statistics, November, 1908.
—— Mortality from Respiratory Diseases in Dusty Trades (Inorganic Dusts) Bulletin
No. 231, United States Bureau of Labor Statistics, June, 1918.
------ “ Mortality from tuberculosis in dusty trades,” in Occupational Diseases, by
Kober & Hanson, November, 1915.
------ “ Prevention of disease by the elimination of dust,” in Proceedings of the First
National Conference of Mayors, June, 1910.
------ Second Preliminary Report on the Mortality from Tuberculosis in Dusty Trades,
National Tuberculosis Association, 1919.
------ “ The dust problem in industry,” in Monthly B ulletin, Am erican Museum of
Safety, March, 1914.
“ Incidence of tuberculosis in husband and wife,” by Arnold Minnig, M. D., in the
Medical Officer, London, January 8, 1921.
Industrial Pneumoconiosis, with Special Reference to Dust Phthisis, by Dr. Edgar
L. Collis, Milroy Lectures, 1915, London, 1919.
“ Industrial tuberculosis and the control of the factory dust problem,” by Drs. Win­
slow and Greenburg, in Journal of Industrial Hygiene, January and February
1921.




APPENDIX L.

165

Landis, H. R. M. “ Pathological and clinical manifestations following the inhalation
of dust, in Fifteenth Annual Report of Henry Phipps Institute, 1921; Journal of
Industrial Hygiene, 1919.
“ Mental and physical effects of fresh air,” by McCall and Huestis, in The Scientific
Monthly, 1921.
Miller and Smyth. “ The dust hazard in certain industries,” in Journal of American
Medical Association, March 2, 1918.
“ Miners’ consumption and pulmonary tuberculosis,” in New York Medical Record,
June 1, 1918.
“ Miners’ phthisis,” in The Lancet, London, January 14, 1922.
New York:
A Simple and Inexpensive Respirator for Bust Protection, Bulletin No. 90 of
New York Department of Labor, Albany, 1918.
Hoods for Removing Dust Fumes and Gases, Special Bulletin No. 82 of New York
Department of Labor, May, 1917. Albany, 1917.
Industrial Code Relating to the Removal of Dust, Gases, and Fumes, New York
Department of Labor, 1915.
Occupational Statistics of the Netherlands, contributed to Archiv fur Soziale Hygiene
und Demographie, Leipzig, 1919, by Dr. Prinzing.
Oliver, Sir Thomas. “ Dust and fume: Foes of industrial life,” in Transactions of
Fifteenth International Conference Hygiene and Demography, 1912.
Pancoast-Miller and Landis. “ On a rontgenological study of the effects of dust
inhalation upon the lungs,” in Transactions of the Association of American
Physicians, 1917.
“ Pulmonary silicosis,” note in American Review of Tuberculosis, May, 1921.
Prudden, T. Mitchell. Dust and Its Dangers, New York, 1907.
“ Recent experiments in the control of air dustiness,” by Dr. O. M. Spencer, in
Journal of the Outdoor Life, May, 1921.
Report of the State Geologist on th.e Mineral Industry and Geology of Certain Areas
of Vermont, Bellows Falls, 1910.
Report on Silica, in Annual Report of the Medical Research Council, 1920-21, Lon­
don, 1922.
Reports of the Rhodesia Chamber of Mines, 1902-1910, Bulawayo, 1903-1921.
‘ ‘ Respiratory efficiency in relation to health and disease,” Milroy Lectures, in The
Lancet, London, September 17 to October 8, 1921.
“ Silicosis among stone masons,” note in Tbe Lancet, London, October 1, 1921.
“ Silicosis and tuberculosis among miners, ’ ’ in British Medical Journal, January 1,1921.
“ Silicosis on the Rand,” in The Lancet, London, January 1, 1921.
“ Spontaneous pneumoconiosis in the guinea pig,” by Henry S. Willis, in The
American Review of Tuberculosis, May, 1921.
“ Studies on the relation of dust to the spread of tuberculosis,” by Sweany and MacLane, in Illinois Medical Journal, December, 1919.
The ash of silicotic lungs, by Dr. John McCrae, South African Institute for Medical
Research, Johannesburg, 1913.
“ The diagnosis of pulmonary tuberculosis from the standpoint of the industrial
physician,” by Dr. Frank A. Craig, in New York Medical Record, April 1, 1922.
“ The dust peril,” by the Medical Correspondent of the London Times, Times Trade
Supplement, November 15, 1919.
‘‘ The epidemiology of tuberculosis,” in British Medical Journal, April 16, 1921.
The Hygiene Diseases and Mortality of Occupation, by Dr. J. T. Arlidge, London^
1892 (with supplementary chapter on the “ Inhalation of dust, its pathology and
symptomatology’ ’).




166

DUST PH TH ISIS IN THE GRANITE-STONE INDUSTRY.

*

“ The influence of dust inhalation upon the incidence-of phthisis, ” by Dr. Edgar L.
Collis}in The Lancet, London, January 22,1921; Public Health, London, March,
1921.
The Nature of the Doubly Refracting Particles Seen in Microscopic Sections of
Silicotic Lungs, and an Improved Method for Disclosing Siliceous Particles
in Such Sections, by Drs. W. Watkins Pitchford and James Moir, Johannesburg,
South Africa, 1916.
»
“ The relation of health to atmospheric environment,” by Leonard Hill, M. D.?
and M. Greenwood, in International Journal of Public Health, May-June, 1921,
Geneva, Switzerland.
“ The silicosis scheme,’ ’ in The Lancet, London, May 24, 1919.
“ Tuberculosis of husband and wife,” by Harry Lee Barnes, in American Review of
Tuberculosis, October, 1921.
“ tiber die Lungenerkrankungen der Steinhauer, von Regierungs und Medizinal-rat
Dr. Franz Koelsch, in Zentralblatt fur Gewerbehygiene, Vol. I ll , pp. 259-264,
273-279, Berlin, 1915.
Union of South Africa:
Preliminary Report of the Miners’ Phthisis Prevention Committee, 1912, Cape
Town, 1913.
Report of the Commission on Miners’ Phthisis and Pulmonary Tuberculosis,
Cape Town, 1912.
First Annual Report of the Miners’ Phthisis Board, 1913, Cape Town, 1914.
Report of the Tuberculosis Commission, Cape Town, 1914.
Second Annual Report of the Miners’ Phthisis Board, 1914, Cape Town, 1915.
Third Annual Report of the Miners’ Phthisis Board, 1915, Cape Town, 1916.
Third Final Report of the Select Committee on the Working of the Miners*
Phthisis Acts, Cape Town, 1916.
General Report of the Miners’ Phthisis Prevention Committee, Pretoria, 1916.
Miners’ Phthisis Board and Miners’ Phthisis Medical Bureau Interim Reports,
1916, Cape Town, 1917.
Fourth Annual Report of the Miners’ Phthisis Board, 1916, Cape Town, 1917.
Annual Report of the Miners’ Phthisis Board, 1917, Cape Town, 1918.
Annual Report of the Miners’ Phthisis Board, 1918, Cape Town, 1919.
Report of the Commission of Inquiry into the Working of the Miners’ Phthisis
Acts, Cape Town, 1919.
Final Report of the Miners’ Phthisis Prevention Committee, Pretoria, 1919.
Act to Consolidate and Amend Acts Relating to Miners’ Phthisis, Cape Town, 1919.
Annual Report of the Miners’ Phthisis Board, 1919, Cape Town, 1920.
Annual Report of the Miners’ Phthisis Board, 1920, Cape Town, 1921.
Annual Report for the Secretary of Mines and Industries, Miners’ Phthisis Sec­
tion, Pretoria, 1921.
Reports of the Transvaal Chamber of Mines, 1911-1920, Johannesburg, 1912-1921.
United States:
Eleventh Census of the United States, Vital Statistics, 1‘Marble and stone cutters, ”
p. 143, Washington, 1896.
Investigation of Dust in the Air of Granite-Working Plants, by S. H. Katz,
Serial No. 2213, Reports of Investigations, United States Bureau of Mines,
February, 1921.
Miners’ Consumption in the Mines of Butte, Mont., Technical Paper No. 260,
United States Bureau of Mines, Washington, 1921.
Mortality from Consumption in Certain Occupations Exposed to Municipal and
General Organic Dust, Bulletin No. 82, United States Bureau of Labor Statis­
tics, May, 1909.




APPENDIX I.

167

United States— Concluded.
Mortality from Consumption in Dusty Trades, Bulletin No. 79, United States
Bureau of Labor Statistics, November, 1908.
Mortality from Respiratory Diseases in Dusty Trades (Inorganic Dusts), Bulletin
No. 231, United States Bureau of Labor Statistics, June, 1918.
Pulmonary Disease Among Miners in the Joplin District of Missouri, preliminary
report of the United States Bureau of Mines, Washington, 1915.
Silicosis Dust in Relation to Pulmonary Disease Among Miners in the Joplin
District of Missouri, United States Department of Mines, Washington, 1917.
The Development of the Ax-Making Industry in the United States, by Prof.
C. E. A. Winslow and Dr. Leonard Greenburg, United States Public Health
Reports, October 8, 1920.
The Efficiency of Certain Devices Used for the Protection of Sand Blasters Against
the Dust Hazard, United States Public Health Service, Washington, 1920.
The Granites of Vermont, by T. Nelson Dale, United States Geological Survey,
Washington, 1909.
Twelfth Census of the United States, Vital Statistics, “ Marble and stone cutters, ”
p. cclxxxv, Washington, 1902.
Ventilation in Metal Mines, by Daniel Harrington, Technical Paper No. 251,
United States Bureau of Mines, Washington, 1921.
*1What we do not know regarding tuberculosis,” by Dr. Nathan Raw, M. P., presi­
dent of the Tuberculosis Society, in The Lancet, London, June 18, 1921.
Workmen’s Compensation (Silicosis) Act, 1918, Circular A. S. 203, National Health
Insurance, London.
Workmen’s Compensation (Silicosis) Act, 1918, Post Magazine and Insurance Monitor,
February 8, 1919.







INDEX.

Aberdeen, Scotland:
Page.
Analysis of granite-stone dust, Barre, V t., and...................................................................... .............. 145-149
Dust phthisis experience................................................................................................................................ 15-22
Masons and stonecutters, deaths of, from phthisis...................................................................................
19
Stone workers,mortality............................................................................................................................ 149-152
Absence on account of sickness, granite workers of Barre, V t., and limestone workers of Lawrence
County, I.nd...........................................................................................................................................................
89
Age at death, average:
Granite cutters.................................................................................................................................................. 82-85
S andstone and limestone cutters, and glass-bottle blowers, United States and Canada............. ...
83
Stonecutters and masons, Aberdeen, Scotland...................................................................................... 151,152
Age incidence in dust phthisis, Aberdeen, Scotland...................................................................................... 18,19
Agriculturists, coal miners, and stone workers in Derbyshire County, England, mortality of, from .
pulmonary tuberculosis......................................................................................................................................
32
Ame rican industrial dust investigations..................................................................................................., . . 123,124
Analysis of various stones:
Chemical. Granite samples............................................................................................................................
23
------ Granite, sandstone, and limestone...................................................................................................... 87,94
Microscopic. Granite-stone dust.................................................................................. .*........................... 145-149
Typical. Granite, sandstone, slate, limestone, and marble................................................................ 109-112
Asphalt, cement, ana gypsum workers, Switzerland, mortality of............................................................. 98,99
Asthma, mortality from, of glass-bottle blowers, sandstone, limestone, and granite cutters.................
95
Australia (Bendigo) tuberculosis investigation............................................................................................. 121-123

B.
Barre district, Vermont, sanitary topography of.............................................................................................
24
Barre, V t,, granite cutters:
Average height and weight of, compared with that of coal miners, andmedieo-actuarial standard.
48
Distribution of, by overweight and underweight..................................................................................... 50, 51
Distribution of, by years of employment in present occupation........................................................... 80,81
Distribution of, by years of exposure to granite dust..............................................................................
45
Medical investigation of, report of committee on mortality from tuberculosis in dusty trades.. 153-161
Barre, V t., granite-cutting industry:
Employees and manufacturers of, living, age distribution of................................................................
47
Occupations, analysis of...................................................................., . ..........................................................
45
Barre, V t., and Aberdeen, Scotland, analysis of granite-stone dust....................................................... 145-149
32
Barre, Vt., and Quincy ,Mass., granite cutters, mortality of, from pulmonary tuberculosis..................
Bedford, Ind., granite (Gutters, distribution of, by years of employment in present occupations........... 80,81
Bed setters, granite-cutting industry, Barre, V t., occupational changes of.........................................71,75,77
Bed setters,polishers, and sawyers, Barre, V t., distribution of, by tuberculosis history in family
and home hygienic conditions........................................................................................................................... 53-55
Bell System telephone companies, eastern group, male employees, mortality of............... .....................
41
Bendigo, Victoria:
Quartz miners, mortality of. From all causes, compared with that of granite cutters of United
States and Canada.........................................................................................................................................
45
------From pulmonary tuberculosis, compared with that of granite cutters of United States and
Canada ...........................................................................................................................................................
44
Tuberculosis investigation........................................................................................................................... 121-123
Bibliography..................................... .................................................................................................................. 163-167
Boxers, lumpers, and derrick men, Barre, V t .:
Distribution of by tuberculosis history in family and home hygienic conditions............................... 53-56
Occupational changes, present and previous employments........................................ ............................ 69-77
Brick and lime burners, Switzerland, mortality of........................................................................................... 98,99
British Medica 1Research Committee, recommendations of............ ............................. . . . . . .......................
8
British silicosis act, 1918, discussion of............................................................................................................. 132,133
Bronchitis, influenza, and pneumonia, mortality from, of granite cutters, B arre, V t...............................
41
94
Bronchitis, mortality from, of glass-bottle blowers, sandstone, limestone, and granite cutters...............
Brooklyn and Chicago, selected groups of workingmen in, room accommodation in homes of...................
57
Building trades, mortality in, Netherlands...................................... .....................- ....................................... 100,101
C.
Caledonia and Washington Counties, V t.:
Farmers' families, mortality in.................... *..................................................................................... . .......62,63
Granite cutters’ families, mortality i n . . . . , ....................................................... ................................ 60,61,65-67
Granite manufacturers, mortality of, from pulmonary tuberculosis.................... .................................
86
Cancer and other malignant tumors, mortality from, of glass-bottle blowers, sandstone, limestone,
and granite cutters................................................... .............................................................*............................
95
Carpenters, Netherlands, mortality of............................................................................................................. 100-102
Cement, gypsum, and asphalt workers, Switzerland, mortality of.............. —....................... , .................... 98,99
Cteemlcal analysis of granite, sandstone, limestone, etc....................................... ..............., ............ .
.23,87,94
Chicago and Brooklyn, selected groups of workingmen in, room accommodation in homes of..........
57




169

170

INDEX.

Coal miners:
Page.
Agriculturists and stoneworkers, Derbyshire County, England, mortality of, from pulmonary
tuberculosis....................................................................................................................................................
32
Average height and weight of, compared with that of granite cutters of Barre, V t., and medicoactuarial standard.; .....................................................................................................................................
48
Bituminous, mortality of, from influenza and pneumonia.....................................................................
41
England and Wales, mortality of........................................................................................................ 104,105,107
Committee on the mortality from tuberculosis in dusty trades, National Tuberculosis Association,
report of, on medical investigation of granite cutters of Barre, V t....................................................... 153-161
Connecticut, Massachusetts, and Rhode Island, granite cutters, mortality of, from pulmonary tuber­
culosis.....................................................................................................................................................................
30
Cutlers and scissors makers, England and Wales, mortality of................................................................. 104-107
Cutlery, tool, and instruments makers, England and Wales, mortality of................................................
38

Death certificates, analysis of, Caledonia and Washington Counties, V t .................................................. 24,25
Deaths and death rates:
Agriculturists, coal miners, and specified stoneworkers, pulmonary tuberculosis, Derbyshire
County, England..........................................................................................................................................
32
Asphalt'cement, and gypsum workers, Switzerland. All causes.......................................................
98
------Pulmonary tuberculosis...........................................................................................................................
99
Bakers, lung diseases, Aberdeen, Scotland................................................................................................. 17,18
Brick and lime burners, Switzerland. All causes...................................................................................
98
------ Pulmonary tuberculosis..........................................................................................................................
99
Building trades, Netherlands. All causes.................................................................................................
100
------Pulmonary tuberculosis..........................................................................................................................
101
Carpenters, Netherlands. All causes..........................................................................................................
ICO
------Nontuberculous respiratory diseases....................................................................................................
102
------ Pulmonary tubercu losis..........................................................................................................................
101
Carters, lung diseases, Aberdeen, Scotland................................................................................................ 17,18
Cement, asphalt, and gypsum workers, Switzerland. All causes........................................................
98
------Pulmonary tuberculosis...........................................................................................................................
99
Clerks, lung diseases, Aberdeen, Scotland................................................................................................. 17,18
Coal miners. All causes, England and Wales..........................................................................................
104
------ Bituminous, from influenza and pneumonia, United States..........................................................
41
------Lung diseases, Aberdeen, Scotland....................................................................................................... 17,18
------Nontuberculous respiratory diseases, England and Wales..............................................................
107
------Pulmonary tuberculosis, England and Wales....................................................................................
105
------Stoneworkers, and agriculturists, from pulmonary tuberculosis, Derbyshire County, Eng­
land..........................................................................................................................................................
32
Comb makers, lung diseases, Aberdeen, Scotland..................................................................................... 17,18
Cutlers and scissors makers, England and Wales. All causes........................................................... 105,106
------ Nontuberculous respiratory diseases....................................................................................................
107
------ Pulmonary tuberculosis....................................................................................................................... 105,106
38
Cutlery, instrument, and tool makers, nontuberculous respiratory diseases and all causes...........
Decorators and painters, Netherlands. All causes..................................................................................
100
------ Nontuberculous respiratory diseases....................................................................................................
102
------ Pulmonary tuberculosis..........................................................................................................: ..............
101
Domestic servants, lung diseases, Aberdeen, Scotland........................................................................... 17,18
Dressmakers and milliners, lung diseases, Aberdeen, Scotland............................................................. 17,18
Engineers, blacksmiths, riveters, and firemen, lung diseases, Aberdeen, Scotland.......................... 17,18
Families of farmers, from specified causes, Washington and Caledonia Counties, V t...................... 62,63
Families of granite cutters, from specified causes, Washington and Caledonia Counties, V t ....... 60,61
Families other than those of granite manufacturers and employees, Washington and Caledonia
Counties, V t...................................................................................................................................................
66
Farmers, Switzerland. All causes...............................................................................................................
98
------ Pulmonary tuberculosis...........................................................................................................................
99
File makers, England and Wales. All causes....................................................... ...................................
104
------ Nontuberculous respiratory diseases....................................................................................................
107
------ Pulmonary tuberculosis...........................................................................................................................
106
Glass blowers, Netherlands. All causes......................................................................................................
100
------ Pulmonary tuberculosis...........................................................................................................................
101
Glass-bottle blowers, United States and Canada. Asthma...................................................................
95
------ Bronchitis....................................................................................................................................................
94
------ Cancer and other malignant tumors......................................................................................................
95
------ Organic diseases of heart..........................................................................................................................
95
------ Pneumonia..................................................................................................................................................
94
------ Pulmonary tuberculosis...........................................................................................................................
93
------ Specified causes..........................................................................................................................................
96
------ Tubercul osis of lungs.............. ..................................................................................................................
94
Granite cutters, Barre, Vt. All causes................................................................................................ 97,100,103
------ Influenza and pneumonia........................................................................................................................
41
------ Influenza, bronchitis, and pneumonia..................................................................................................
41
------ Influenza, pneumonia, and pulmonary tuberculosis.........................................................................
40
------ Nontuberculous respiratory diseases..............................................................................................37,102,106
------ Pulmonary tuberculosis, by exposure to granite dust....................................................43,44,99,101,105
------ Pulmonary tuberculosis, nontuberculous respiratory diseases, and all causes............................. 36,38
Granite cutters, Barre?Vt., and Quincy, Mass., pulmonary tuberculosis..............................................
32
Granite cutters’ families, pulmonary tuberculosis, Barre, V t .................................................................
68
Granite cutters’ families, specified causes, Washington and Caledonia Counties, V t............................60,61
Granite cutters, Maine and New Hampshire. All causes and pulmonary tuberculosis......................
86
------ Pulmonary tuberculosis..........................................................................................................................
28
27
Granite cutters, Massachusetts, pulmonary tuberculosis........................................................................
Granite cutters, Massachusetts, Connecticut, and Rhode Island.........................................................
86
Granite cutters, Netherlands. All causes....................... ...........................................................................
100
------Pulmonary tuberculosis...........................................................................................................................
101




INDEX.

171

Deaths and death rates—Continued.
Page.
Granite cutters, New England States. Asthma...................................................................................... 34,95
------Bronchitis...................................................................................................................................................34,94
------ Cancer and other malignant tumors......................................................................................................34,95
------Organic diseases of heart..........................................................................................................................34,95
------ Pneumonia..................................................................................................................................................34,94
------ Pulmonary tuberculosis...................................................................................................................... 28,39,93
------ Specified causes.......................................................................................................................................... 33,96
------Tuberculosis of lungs................................................................................................................................ 34,94
Granite cutters, specified granite-cutting centers, pulmonary tuberculosis.........................................
29
Granite cutters, United States and Canada. All causes............................................................... 25,26,45,91
------ All causes, and average age at death.................................................................................................... 82,83
------ All causes, by age at death.....................................................................................................................
85
------ Pulmonary tuberculosis, nontuberculous respiratory diseases, and all causes...........................35,36
Granite cutters, Vermont. Pulmohary tuberculosis...............................................................................27,93
------ Pulmonary tuberculosis, and all causes..............................................................................................84,86
Granite manufacturers, all causes, and pulmonary tuberculosis, Washington and Caledonia
Counties, V t ...................................................................................................................................................
86
Granite manufacturers and employees, specified causes, Washington and Caledonia Counties, V t. 65,67
Granite polishers, pulmonary tuberculosis, Barre, V t., and Quincy, Mass........................................
32
Gypsum, cement, and asphalt workers, Switzerland. All causes.......................................................
98
--------- Pulmonary tuberculosis.......................................................................................................................
99
Instrument, tool, and cutlery makers, pulmonary tuberculosis, nontuberculous respiratory dis­
38
eases, and all causes, England and W ales.............................................................................................
Ironstone miners, England and Wales. All causes.................................................................................
104
—— Nontuberculous respiratory diseases................................................................................................
107
------Pulmonary tuberculosis.........................................................................................................................
105
Joiners, sawyers, shipwrights, and cabinetmakers, lung diseases, Aberdeen, Scotland................... 17,18
Laborers, lung diseases, Aberdeen, Scotland............................................................................................. 17,18
Lead miners, England and Wales. All causes....................................................................................... 103,104
------Nontuberculous respiratory diseases.................................................................................................. 106,107
------Pulmonary tuberculosis..........................................................................................................................
105&
Lime and brick burners, Switzerland. All causes...................................................................................
98
------Pulmonary tuberculosis..........................................................................................................................
99
Limestone and sandstone cutters, all causes, United States and Canada...........................................
78
Limestone cutters, United States and Canada. All causes...................................................................
91
------Asthma........................................ . .............................................................................................................
95
------Bronchitis.................................... . .............................................................................................................
91
------ Cancer and other malignant tumors.....................................................................................................
95
------Organic diseases of heart..........................................................................................................................
95
------ Pneumonia...................................................... ! .........................................................................................
94
------ Pulmonary tuberculosis..........................................................................................................................
93
------ Specified causes, each of..........................................................................................................................
96
------ Tuberculosis of lungs................................................................................................................................
94
32
Lumpers, boxers, and derrick men, pulmonary tuberculosis, Barre, V t., and Quincy, Mass.........
Marble and stone workers, insured, pulmonary tuberculosis.................................................................
84
Masons and stone cutters, pulmonary tuberculosis and t>ther causes, Aberdeen, Scotland......... 150-152
Masons, Netherlands. All causes................................................................................................................
100
— — N ontuberculous respiratory diseases...................................................................................................
102
------ Pulmonary tuberculosis..........................................................................................................................
101
Occupations, specified, with exposure to mineral and metallic dusts, pulmonary tuberculosis. 141-143
Painters and decorators, Netherlands. All causes..................................................................................
100
------ Nontuberculous respiratory diseases....................................................................................................
102
------ Pulmonary tuberculosis.................. .......................................................................................................
101
Painters, lung diseases, Aberdeen, Scotland..............................................................................................17,18
Paper hangers, Netherlands. All causes...................................................................................................
100
------ Nontuberculous respiratory diseases....................................................................................................
102
------ Pulmonary tuberculosis..........................................................................................................................
101
Plasterers, Netherlands. All causes............................................................................................................
101
------N ontuberculous respiratory diseases....................................................................................................
102
------Pulmonary tuberculosis..........................................................................................................................
101
Population, adult, all causes, New England........................................................................................ 25,26,91
28
Population, adult, pulmonary tuberculosis. Maine and New Hampshire.......................................
------Massachusetts............................................................................................................................................ 27,93
------New England States................................................................................................................................
28
------Vermont......................................................................................................................................................
27
Population, all occupied males. All causes, England and Wales.......................................................
104
------All causes, Switzerland............................................................................................................................
98
------Nontuberculous respiratory diseases, England and Wales.................................... . .......................
107
------ Pulmonary tuberculosis, England and Wales....................................................................................
106
------Pulmonary tuberculosis, Switzerland..................................................................................................
99
Population, males and females, pulmonary tuberculosis, Aberdeen, Scotland.................................
152
Population, males, pulmonary tuberculosis, Massachusetts.................................................................. 39,99
Pooulation, males, 15 years of age and over, all causes, Massachusetts...............................................
97
Population, males, 20 to 69 years of age. Asthma, Massachusetts....................................................... 34,95
------ Bronchitis, Massachusetts...................................................................................................................... 34,94
------Cancer and other malignant tumors..................................................................................................... 34,95
------Organic diseases of heart.......................................................................................................................... 34,95
------Pneumonia................................................................................................................................................. 34,94
------Pulmonary tuberculosis.......................................................................................................................... 39,99
------Specified causes.......................................................................................................................................... 33,96
------Tuberculosis of lungs............................................................................................................................... 34,94
Potters, pulmonary tuberculosis, nontuberculous respiratory diseases, and all causes, England
and Wales.................................................................... ................. .................................................... .
38
Printers and lithographers, lung diseases, Aberdeen, Scotland............................................................ 17,18
Quartz miners, Bendigo, Victoria. All causes..........................................................................................
45
------Pulmonary tuberculosis..........................................................................................................................
44
Sandstone and limestone cutters, all causes, United States...................................................................
78

61928°— 22— Bull. 293------ 12




172

IKDEX.

Deaths and death rates—Concluded.
Pi®*.
Sandstone cutters, United States and Canada* All causes....................................................................
91
■
Asthma.......................................................................................................................................................
95
------ Bronchitis................................................................................................................................. 94
------ Cancer and other malignant tumors.............................................................................................. 1. ] ]
95
------ Organic diseases of heart..........................................................................................................................
95
------ Pneumonia.......................................................................................................................................... 94
------ Pulmonary tuberculosis.......................................................................................................................] ]
93
------ Specified causes, each o f...........................................................................................................................
95
------ Tuberculosis of lungs................................................................................................................................
94
Scissors makers and cutlers, England and Wales. All causes..............................................................
104
------ NontubeFculous respiratory diseases....................................................................................................
107
------ Pulmonary tuberculosis....................................................................................................................... 105,106
Stone and slate quarriers, England and Wales. AH causes..................................................................
103
------ Nontubercuious respiratory diseases....................................................................................................
106
------ Pulmonary tuberculosis...........................................................................................................................
105
Stonecutters. All causes, Netherlands.......................................................................................................
100
------ All causes, Switzerland............................................................................................................................ 97,98
------Nontuberculous respiratory diseases, Netherlands............................................................................
102
------ Pulmonary tuberculosis, Netherlands..................................................................................................
101
------ Pulmonary tuberculosis, Switzerland...................................................................................................
99
Stonecutters and masons, Aberdeen, Scotland. Lung diseases............................................................ 17,18
------ Lung diseases and phthisis.....................................................................................................................
19
------ Pulmonary tuberculosis and other diseases........................................................................... *.___ 150-152
Stone polishers and sawyers, lung diseases, Aberdeen, Scotland.......................................................... 17,18
Tailors,lung diseases, Aberdeen, Scotland..................................................................'.............................. 17,18
Telephone employees, male, Bell System (east), influenza, bronchitis, and pneumonia....................
41
Tin miners, England and Wales. All causes............................................................................................
103
------ Nontubercuious respiratory diseases, pulmonary tuberculosis, and all causes.............................
38
------ Nontubercuious respiratory diseases.....................................................................................................
106
------ Pulmonary tuberculosis...........................................................................................................................
105
Tool, instrument, and cutlery makers, pulmonary tuberculosis, nontubercuious respiratory
diseases, and all causes, England and Wales..........................................................................................
38
Tool sharpeners, pulmonary tuberculosis, England and Wales.............................................................
32
Derrick men, boxers, and lumpers, Barre, V t.:
Age, average, and years in present occupation..........................................................................................
77
Distribution of, by tuberculosis history in family and home hygienic conditions........................ 53,55
Homes of, sanitary, conditions as to cleanliness, light, and air...............................................................53-56
Occupational changes, present and previous employments.................................................................... 71,76
Diagnostic difficulties in early phthisis...............................................................................................................
126
Disease symptoms, fibrosis, differentiation of...................................................................................................
129
Draftsmen, Barre, V t., granite-cutting industry:
Age, average, and years in present occupation..........................................................................................
77
Distribution of, by years in present occupation and previous employments.....................................
74
Distribution of, by tuberculosis history m family and home hygienic conditions.......................... 52,55
Homes of, sanitary conditions as to cleanlmess, light, and air...............................................................52-56
Dust:
Distribution of living granite cutters of Barre, Vt., and limestone cutters and planer men of
Lawrence County, Ind., by years of exposure t o ..................................................................................
79
Distribution of living granite cutters of Barre, V t., by years of exposure to.......................................
45
Inhalation, pathology of.................................................................................................................................. 13,14
Investigations, American............................................................................................................................ 123,124
Mineral, occupations with exposure to, living males in, age distribution of......................................
47
Mineral, trades with exposure to, incidence of pulmonary tuberculosis in ..................................... 140-144
Mortality from pulmonary tuberculosis, granite cutters, Barre, V t.....................................................
43
Mortality from pulmonary tuberculosis, nontubercuious respiratory diseases, and all causes,
Netherlands....................................................................................................................................................
103
Phthisis, age incidence in, Aberdeen, Scotland, experience.............................................. ................... 18'19
Problem, mineralogy of..................................................................................................................................
144
Dusty occupations, cases of tuberculosis following employment in .............................................................
135
Dusty trades, specified, living males in, age distribution of, and in granite-cutting industry,
compared................................................................................................................................................................. 46,47
Dutch occupational experience.......................................................................................................................... 100-103
E.
Electricians, firemen, engineers, and machinists, granite industry, Barre, V t.:
Distribution of, by tuberculosis history in family, and home hygienic conditions......................... 53,55
Homes of, sanitary conditions, as to cleanliness, light, and air........................................................... 53-56
Occupational changes, present and previous employments...................................................................74,77
England and Wales:
Mortality in specified occupations in, from pulmonary tuberculosis, nontubercuious respiratory
1diseases, and all causes............................................................................................................................. 103-107
Tenements, and granite cutters' homes, comparison of, as to overcrowding.....................................
58
F.
Families of granite cutters, mortality in............................*.............................................................................. 5&-61
Family, home hygienic conditions, granite-cutting industry, Barre, V t.................................................. 52-55
Family infection, absence of.................................................................................................................................. 58,59
Family infection, problem of, in dust phthisis, Aberdeen, Scotland....................................... ...................
21
Family mortality records of farmers, Washington and Caledonia Counties, V t ..................................... 62,63
Family mortality records of granite cutters, Washington and Caledonia Counties, V t .......................... 60,61
Family, tuberculosis history in, and home hygienic conditions, employees and manufacturers,
granite-cuttingindustry, Barre, V t............................................................................................................. 52,53,55
Farmers and all occupied males, Switzerland, mortality of, compared:
All causes.............................................................................................................................................................
98
Pulmonary tuberculosis............................................................. .....................................................................
99




INDEX.

173

Page.
Farmers of Washington and Caledonia Counties, V t., family mortality of...................................... a . . . 62,63
Fibrosis of lungs, symptoms, differentiation of................................................................................................
129
File makers, England and Wales, mortality of:
All causes............................................................................................................................................................
104
NontUbercuIous respiratory diseases............................................................................................................
107
Pulmonary tuberculosis...................................................................................................................................
106
Firemen, engineers,electricians, and machinists, granite industry, Barre, V t.:
Distribution of, by tuberculosis history in family and home hygienic conditions............................ 53,55
Homes of, sanitary conditions, as to cleanliness, light, and air...............................................................53-56
Occupational changes, present and previous employments....................................................................74,77
Foremen and manufacturers, granite-cutting industry, Barre, Vt., average age and years in present
occupations............................................................................................................................................................
74
G.
German occupational experience, stoneworkers............................................................................................ 120,121
Glass-bottle blowers, average age at death, United States and Canada......................................................
83
Glass-bottle blowers, sandstone and limestone cutters, United States and Canada:
Comparative mortality of............................................................................................................................... 89-96
Deaths, from all causes.................................................................................................................................... 78,91
Deaths, from pulmonary tuberculosis.........................................................................................................
93
Deaths, from specified causes......................................................................................................................... 94-96
Glass cutters and blowers, Netherlands, mortality of:
All causes............................................................................................................................................................
100
Pulmonary tuberculosis..................................................................................................................................
101
Gold miners, living, distribution of, by years in present occupation, Transvaal.. ................................. 80,81
Granite cutters:
Barre, Vt. Age, and years of exposure to granite dust, distribution by...................................... 45,78,79
------Age distribution of, by occupation groups..........................................................................................
47
------Age distribution of, compared with that in specified dusty trades............................................... 46,47
------Anthropometry of, comparative, by birthplace of workman’s mother. . . ■.......... : .....................
49
------Families of, deaths in, from pulmonary tuberculosis.......................................................................
68
------Height and weight, average.................................................................................................................... 48,49
------Homes of, room accommodation in ...................................................................................................... 57,58
------Homes of, sanitary conditions as to cleanliness, light, and air...................................................... 53-56
------Influenza, pneumonia, and pulmonary tuberculosis, mortality from...........................................
40
------Nontuberculous respiratory diseases, mortality from................................................................. 102,106
------ Occupational changes, present and previous employments............................................................ 71-77
------Occupation, present, years employed in, distribution by................................................................ 80,81
------ Occupations, 50 most important previous, distribution b y ........................................................ 69,70
------Pulmonary tuberculosis, mortality from......................................................................................... 101,105
------Pulmonary tuberculosis, mortality from, by years of exposure to dust......................................
43
------Pulmonary tuberculosis, nontuberculous respiratory diseases, and all causes............ 36-38,103-107
------Tuberculosis history in family, and home hygienic conditions, distribution b y.....................
53
------Tuberculosis investigation, medical, report of................................................................................ 153-161
New England. Families of, mortality in, Washington and Caledonia Counties, V t........... 60,61,65-67
------Pulmonary tuberculosis, mortality from.............................................................................................
28
------Pulmonary tuberculosis, mortality from, Maine and New Hampshire........................................
28
------Pulmonary tuberculosis, mortality from, Massachusetts................................................................
27
------ Pulmonary tuberculosis, mortality from, Massachusetts, Connecticut, and Rhode Island...
30
------Pulmonary tuberculosis, mortality from, Vermont................................ „.................................. 26,27,30
------ Specified causes, mortality from...................................................................................................... 33,94-96
United States and Canada. Age at death............................................................................................ 82,83,85
------ All causes, mortality from...................................................................................................................... 25, 26
------Pulmonary tuberculosis, mortality from.............................................................................................
30
------Pulmonary tuberculosis, nontuberculous respiratory diseases, and all causes, mortality
from................................................................................................................................................................. 35,36
Granite Cutters’ International Association, mortality experience of........................................................... 25-27
Granite-cutting centers, principal, mortality from pulmonary tuberculosis in ........................................
29
Granite-cutting i ndustry:
Age distribution oi living males in, Barre, V t...........................................................................................
46
Age distribution olmanufacturers and employees in specified occupations in, Barre, V t ..............
47
Analysis of, by occupations, Barre, V t.......................................................................................................
45
Occupational mortality in ..............................................................................................................................31,32
Sanitary conditions as to cleanliness, light, and air, in homes of specified workmen, Barre, V t . . 52-56
Workersin, distribution of, by 50 most important previous occupations, Barre, V t .......................69,70
Workersin, occupationa jhistory of, Barre, V t ........................................................................................
71
Granite,limestone, sandstone, and marble, typical analysis of....................................................................
87
Granite manufacturers and foremen:
Previous occupations of, Barre, V t ..............................................................................................................
72
Years in present occupation, and average age...........................................................................................
77
Granite manufacturers of Washington and Caledonia Counties, V t., mortality of................................ 85,86
Granite polisher s and sawyers, average age and years in present occupation, Barre, V t .......................
77
Granite polishers, previous occupations of, Barre, V t ....................................................................................
72
Granite samples, chemica 1analysis.....................................................................................................................
23
Granite, sandstone, and limestone, chemical analysis of................................................................................
94
Granite-stone dust, analysis of, Barre, Vt.,and Aberdeen, Scotland..................................................... 145-149
Granite, typical analysis of...................................................................................................................................
109
Graphic presentation ofresults of present investigation (6 charts).......................................................... 113-119
Greek and Italian workingmen, Chicago, room accommodation in homes of...........................................
57
Gypsum, cement, and asphalt workers, Switzerland, mortality of. All causes......................................
98
------Pulmonary tuberculosis..........................................................................................................................
99

H.
Heart, organic diseases of, mortality from, of glass-bottle blowers, sandstone, limestone, and granite
cutters....................................................................................................................................................................
Height and weight, average, of granite cutters, Barre, V t., and coal miners, comparison of.................




95
48

174

INDEX.

Height atfd weight, average, ef granite eutters, Barre, Vt., by birthplace of workman's mother........
49
Homes -of manufacturers €md employees in granite-cutting industry, Barre, V t., room accommoda­
tion in ....................................................................................................................................................... ............. 56-58
Hygienic-conditions. (See Sanit-ary conditions.)

I.
Idleness, involuntary, distribution by, of granite workers, Barre, V k , and limestone workers of
Lawrence County, in d ........................................................................................................................................
89
infection, evidence as to, inconclusive................................................................................................................ 64-68
Infection, family, problem of, in dust phthisis, Aberdeen, Scotland...........................................................
21
Infection from dust, problem of........................................................................................................................ 126,127
Influenza, mortality from, effect of the stone industry on............................................................................. 39-42
Influenza, pneumonia, and pulmonary tuberculosis, mortality from, of granite cutters, Barre, V t.,
during epidemic period.......................................................................................................................................
40
Instrument, tool, and cutlery makers, England and Wales, mortality of, from pulmonary tubercu1 osis, nontuberculous respiratory diseases, and all causes...........................................................................
38
Ironstone miners, England and Wales, mortality of:
All causes............................................................................................................................................................
104
Nontuberculous respiratory diseases............................................................................................................
107
Pulmonary tuberculosis..................................................................................................................................
105
Italian and Greek workingmen, Chicago, room accommodation in homes of............................................
57
Italy, Scotland, and Spain, height and weight of granite cutters whose mothers were bom in ............49-51

£j.
Lawrence County, Ind.?limestone workers, distribution of, by absence on account of sickness, vaca­
tion, and involuntary idleness............................................................................................................................
89
Lead miners, England and Wales, mortality of:
All causes.................. •.................................................................................................................................... 103,104
Nontuberculous respiratory diseases.........................................................................................................106,107
Pulmonary tuberculosis..................................................................................................................................
105
lim e and brick burners, Switzerland, mortality of:
All causes............................................................................................................................................................
98
Pulmonary tuberculosis..................................................................................................................................
99
Limestone and marble, typical analysis of.......................................................................................................1 112
Limestone and sandstone cutters:
Average age at death, United States and Canada...................................................................................
83
Distribution of, by age groups, Bedford, Ind.............................................................................................
78
limestone and sandstone cutters and glass-bottle blowers, United States said Canada:
Comparative mortality.: ................................................... - ...........................................................................89-96
Mortality, all causes................................................................. ....................................................................... 78,91
Mortality, each of specified causes............................................................................................................... 94,95
Mortality, pulmonary tuberculosis...............................................................................................................
93
limestone cutters and planer men, distribution of, by age and exposure to granite dust, Lawrence
County, Ind............................................................................................................................................................
79
limestone cutters, distribution of, by years in present occupation, Bedford, Ind.......................................80,81
limestone, sandstone, and granite, chemical analysis of..................................................................................
94
limestone, sandstone, and granite cutters and glass-bottle blowers, mortality of, from specified
causes, United States and Canada.....................................................................................................................
96
Limestone workers, comparative mortality of................................................................................................... 78-81
57
Lithuanian workingmen, Chicago, room accommodation in homes of.........................................................
LumperSj boxers, and derrick men, Barre, V t .:
Distribution of, by tuberculosis history in family and home hygienic conditions.................................53,56
Occupational changes, present and previous employments......................................................................69-77
Lung diseases, tuberculous and nontuberculous................................................................................................36,37
Lung fibrosis:
Pathology of.................................................................................................................................................... 128,129
Problem of...................................................................................................................................................... 124,125
M.
Machinists, firemen, engineers, and electricians, granite industry, Barre, V t.:
Distribution of, by tuberculosis history in family and home hygienic conditions.............................53,55
Homes of, sanitary conditions as to cleanliness, fight, and air.............................................................. 53-56
Occupational changes of.................................................................................................................................. 74,77
Maine and New Hampshire, granite cutters, mortality of, from pulmonary tuberculosis..................... 28,31
Manufacturers and foremen in granite industry, Barre, V t., occupational changes of............................73,77
Marble and limestone, typical analysis of...........................................................................................................
112
Marble and stone workers and granite cutters of Vermont, mortality of, from pulmonary tuber­
culosis .....................................................................................................................................................................
84
Marble, limestone, sandstone, and granite, typical chemical analysis o f ....................................................
87
Masons and stonecutters, Aberdeen, Scotland, use of pneumatic tools and deaths from phthisis and
other lung diseases...................................................................... ........................................................................
19
Masons, Netherlands, mortality of:
Allcauses.............................................................................................................................................................
100
N ontuberculous respirat ory diseases.......................................- ...................................................................
102
Pulmonary tuberculosis..................................................................................................................................
101
Massachusetts, Connecticut, and Rhode Island, granite cutters in, mortality of, from pulmonary
tuberculosis...........................................................................................................................................................30
Massachusetts, granite cutters, mortality of, fromjpulmonary tuberculosis..................................................
27
Massachusetts, males, 20 to 69 years of age, mortality of, from specified causes............................................ 33,34
Medical blank recommended in investigations..................................................................................................139,140
Medical observations, suggestive...........................................................................................................................
124
Medical opmaora.s,cmitradictory......................................................................................................................... 130,131
Medico-actuarialstandard of height and weight, and average height and weight of coal miners and
granite cutters,
of.......................................................................................................................... 48,492
Method of present inquiry.......................................................................................................................................11 ,12




INDEX.

175

Mineralogy of the dustproblem.................................................................... .......................................................
144
Miners’ phthisis, or silicosis.................................................................................................................................. .
127
Mortality among granite-stone workers............................................................................................................... 22-59
Mortality among granite cutters of the United States and Canada, by single years of life.....................35, 36
Mortality figures, proportionate, value of............................................................................................................ 29-31
Mortality from all causes among granite cutters of New England and male population of New
England compared................................................................................................................................................33,34
Mortality rates, comparison of:
Granite cutters of Barre, V t., and—
Bituminous coal miners and all occupied males, from influenza and pneumonia.. . . » ...........
41
Male employees of Bell System telephone companies, eastern group...........................................
41
Male population of Massachusetts, from all causes............................................................................
97
37
Male population of Massachusetts, from nontuberculous respiratory diseases............................
Specified workers, England and Wales, from all causes, pulmonary tuberculosis and non­
tuberculous respiratory diseases................................................................................................... 103-107
Specified workers, Netherlands, from all causes................................................................................
100
Specified workers, Netherlands, from nontuberculous respiratory diseases................................
102
Specified workers, Netherlands, from pulmonary tuberculosis.....................................................
101
Specified workers, Switzerland, from all causes................................................................................. 97,98
Specified workers, Switzerland, from pulmonary tuberculosis......................................................
99
Tin miners, potters, etc., of England and Wales, from all causes..................................................
38
Granite cutters of Barre, V t., and Quincy, Mass., and—
Coal miners, agriculturists, and stone workers, Derbyshire County, England, from pul­
monary tuberculosis............................................................................................................................
32
Tool sharpeners, etc., from pulmonary tuberculosis..........................................................................
32
Granite cutters of Connecticut, Massachusetts, and Rhode Island, and—
Granite cutters of Vermont and United States and Canada...........................................................
30
Granite cutters of Maine and New Hampshire, and—
Adult population, from pulmonary tuberculosis...............................................................................
28
Granite cutters of Vermont.....................................................................................................................30,31
Granite cutters of Massachusetts, and—
Adult population, from pulmonary tuberculosis...................................................................... ........
27
Granite cutters of New England States, and—
Adult population, from pulmonary tuberculosis...............................................................................
28
Male population of Massachusetts, from pulmonary tuberculosis.................................................
39
Male population of Massachusetts, from specified causes................................................................ 33,34
Quartz miners, Bendigo, Victoria, from pulmonary tuberculosis..................................................
44
Sandstone cutters of United States and Canada, from specified causes....................................... 94-96
Sandstone cutters of United States and Canada, from pulmonary tuberculosis........................
93
Granite cutters of Vermont, and—
Adult population of the State, from pulmonary tuberculosis........................................................ 26,27
Glass-bottle blowers of United States and Canada............................................................................
93
Granite cutters of United States and Canada, from pulmonary tuberculosis.............................
30
Limestone cutters of United States and Canada, from pulmonary tuberculosis........................
93
Male population of Massachusetts, from pulmonary tuberculosis.................................................
93
Marble and stone workers, from -pulmonary tuberculosis................................................................
84
Sandstone cutters of United States and Canada, from pulmonary tuberculosis........................
93
Granite cutters of United States and Canada, and—
Adult male population of New England, from all causes........................................................... 25,26,91
Granite cutters of Vermont^ from pulmonary tuberculosis............................................................. .. 30
Quartz miners, Bendigo, Victoria, from all causes............................................................................
45
Granite manufacturers of Washington and Caledonia Counties, V t., and—
Granite cutters of New England States, from pulmonary tuberculosis.......................................
86
Granite cutters, sandstone and limestone cutters, United States and Canada, and—
Glass-bottle blowers, from all causes............ ....................................................................................... 78,91
Mortality. (See also Deaths and death rates.)
N.
National Tuberculosis Association, committee cm the mortality from tuberculosis in dusty trades,
report of, on medical investigation of granite cutters of Barre, V t .................................................... 153-461
Netherlands. Mortality in specified occupations in, from—
All causes............... . . . . . . . ..................................... . .................................................................................... 100,103
Nontuberculous respiratory diseases............................................................................................................
102
Pulmonary tuberculosis..................................................................................................................................
101
New England granite cutters, mortality of:
From pulmonary tuberculosis, compared with that of general population........................................ 27-29
From pulmonary tuberculosis, compared with that of granite manufacturers of Washington
and Caledonia Counties, V t ........................................................................................................................
86
From specified causes...................................................................................................................................... 33,34
New Hampshire and Maine granite cutters, mortality of, from pulmonary tuberculosis...................... 28,31

O.
Occupational changes and trade life of granite cutters....................................................................................69-81
Occupational diseases:
Importance of recognition of..........................................................................................................................
«}
In the stone industry........................................................................................................................................
«
Predisposition workers in granite industry to, extent of.................................................................... 71-77
Occupational mortality and morbidity experience in Germany..................................... ........................ 120,121
Occupational mortality of granite cutters, Barre, V t., compared with that of various other occu­
pations in—
Barre and other New England localities..................................................................................................... 31,32
England and Wales..................................................................................................................... 32,37-39,103-107
Netherlands.................................................................................................................................................... 100-103
Switzerland........................................................................................................................................................ 97-99




176

INDEX.

Occupations:
Page;
Analysis of, in granite-cutting industry, Barre, V t.................................................................................
45
Distribution of, in the granite industry....................................................................................
45 46
Distribution of workers in granite-cutting industry in Barre, V t., according to previous’.’ 1111111 69*70
Importance of segregation of.......................................................................................................................... 12’ 13
Open air, and with exposure to dusts, mortality in............................................................................. ”
103
With exposure to metallic and mineral dusts, mortality from tuberculosis in.............................. 141-143
With exposure to mineral dust, age distribution of living males in.....................................................
47
Overcrowding, absence of, in homes of manufacturers and employees in granite-cutting industry
of Barre, V t............................................................................................................................................................55,56
P.
Painters and decorators, Netherlands, mortality of:
A ll causes............................................................................................................................................................
100
N ontuberculous diseases............i ...................................................................................................................
102
Pulmonary tuberculosis..................................................................................................................................
101
Paper hangers, Netherlands, mortality of:
A ll causes............................................................................................................................................................
100
Nontuberculous diseases.................................................................................................................................
102
Pulmonary tuberculosis..................................................................................................................................
101
Pathology of dust inhalation................................................................................................................................. 13,14
Phthisis, miners’ , South Africa............................................................................................................................
8
Physique in relation to race, granite cutters of Barre, V t ............................................................................ 49-51
Physique of granite workers........................................................................................, ........................................46-49
Planer men and limestone cutters, living, distribution of, by age groups, and years of exposure to
dust, Lawrence County, Ind.............................................................................................................................
79
Plasterers, Netherlands, mortality of:
All causes............................................................................................................................................................
100
Nontuberculous respiratory diseases............................................................................................................
102
Pulmonary tuberculosis..................................................................................................................................
101
Pneumatic tools, effect of, in dust phthisis. Aberdeen, Scotland................................................................. 19-21
Pneumonia,influenza, and bronchitis, mortality from, of granite cutters of Barre, V t ..............................
41
Pneumonia, mortality from, of glass-bottle blowers and sandstone, limestone, and granite cutters.......
94
Pneumonia, pulmonary tuberculosis, and influenza, mortality from, of granite cutters, Barre, V t.,
during epidemic period and normal periods..................................................................................................
40
Polishers and sawyers, average age and years in present occupation, Barre, V t......................................
77
Polishers, bed setters, and sawyers, homes of, sanitary conditions as to cleanliness, light, and air,
granite-cutting industry. Barre, V t..................................................................................................................53-56
Population, male, mortality of:
A ll causes, New England................................................................................................................................
91
Nontuberculous respiratory diseases, Massachusetts...............................................................................
37
Pulmonary tuberculosis, Massachusetts.....................................................................................................
93
Specified causes, Massachusetts.......................................................................................................... 33,34,94-96
Tuberculosis, Massachusetts..............................................................................................................: ..........
39
Population, white males, 20 years of age and over, average age at death,from pulmonary tuberculosis,
nontuberculous respiratory diseases, and allcauses, registration area, United States.............................
36
Public Health Service, United States, investigation of...................................................................................
9
Pulmonary tuberculosis, death rates from, Aberdeen, Scotland...................................................................
152
Pulmonary tuberculosis, mortality from, of Bendigo, Victoria, quartz miners, and New England
granite cutters, comparison of............................................................................................................................
44

Q.
Quartz miners, B endigo, Victoria, and granite cutters, United States, mortality of................................... 44,45

R.
Racial and social influences, in dust phthisis, Aberdeen, Scotland, experience...................................
21
References, list of................................................................................................................................................. 163-167
Regularity of employment..................................................................................................................................... 87-89
Rhode Island, Connecticut, and Massachusetts, granite cutters in, mortality of, from pulmonary
tuberculosis...........................................................................................................................................................
30
Room accommodation in homes of manufacturers and employees in granite-cutting industry, Barre,
V t ............................................................................................................................................................................. 56-58
S.
Sandstone and limestone cutters, and glass-bottle blowers, United States and Canada:
Age at death, average, compared with that of granite cutters...............................................................
83
Mortality of, from all causes, compared with that of granite cutters.................................................... 78,91
Mortality of, from specified causes........................................ ....................................................................... 94-96
Mortality of,from pulmonary tuberculosis, compared with that of granite cutters of New England
States.................................................................................................................................. - ...........................
93
Sandstone and limestone cutters, living, distribution of, by age groups, Bedford, Ind..........................
78
Sandstone, limestone, and granite, chemical analysis of.................................................................................
94
Sandstone, limestone, granite, and marble, typical chemical analysis of...................................................
87
Sandstone, typica 1analysis of............................................................................................ ........... - ....................
110
Sanitary conditions as to cleanliness, light, and air, in homes of manufacturers and employees, granite-cutting industry, Barre, V t ............................................................................. - - .......................................
Sawyers and polishers, average age and years in present occupation, Barre, V t ................................... .
77
Sawyers, bed setters, and polishers, homes of, sanitary conditions as to cleanliness, light, and air,
granite-cutting industry, Barre, V t ..................................- ............................................................................. 53-56
Scissors makers and cutlers, England and Wales, mortality of:
All causes............................................................................................................................................................
JJj
Nontuberculous respiratory diseases...............................................................................................i .........107
Pulmonary tuberculosis...............................................................................................................................105,106




SNBEX.

177

Page.
Sfeope of present inquiry......................................................................................................................................... 10-14
Scotch descent, granite gutters of, Barre, Vt., distribution of, by overweight and underweight.........
50
Sickness, absence on account of, distribution by, of granite workers of- Barre, V t., and limestone
workers of Lawrence County, Ind...................................................................................................................
89
British act, discussion of.............................................................................................................................. 132,133
Conclusions as to, restatement of..................................................................................................................
137
Descriptive cases of...................................................................................................................................... 135* 138
Importance of, primary..................................................................................................................................
136
Investigations, recent....................................................................................................................... ........... 133,134
Miners’ phthisis, or........................................................................ ................................................... ............
127
Physical signs of..................................— - ............................................................................... .....................
135
Signs of, and of tuberculosis....................................................................................................................... 129,130
Statistics of, South Africa...............................................................................................................................
132
Slate, typical analysis of........................................................................................................................................
I ll
Slovak workingmen, Chicago, room accommodation in homes of................................................................
57
21
Social and racial influences, in dust phthisis, Aberdeen, Scotland, experience.......................................
South Africa:
Institute of Medical Research, results of inquiry.................................................................................. 131,132
Miners’ Phthisis Commission, investigation of..........................................................................................
127
Silicosis statistics..............................................................................................................................................
132
Spain, Scotland, and Italy, height and weight of Barre, Vt., granite cutters whose mothers were
born in ...........................; ....................................................................................................................................... 49-51
Stone and slate quarriers, England and Wales, mortality of:
All causes............................................................................................................................................................
103
Nontuberculous respiratory diseases...........................................................................................................
106
Pulmonary tuberculosis..................................................................................................................................
105
Stone composition, differences in......................................................................................................................... 86,87
Stone cutters and masons, Aberdeen, Scotland:
Age at death, average.................................................................................................................................. 151,152
Deaths from phthisis and other lung diseases, and use of pneumatic tools........................................
19
Deaths from specified causes...................................................................................................................... 150,151
Stonecutters, mortality of:
All causes, Netherlands..................................................................................................................................
100
All causes, Switzerland................................................................................................................................... 97,98
Nontuberculous respiratory diseases, Netherlands................................................................ : ................
102
Pulmonary tuberculosis, Netherlands.........................................................................................................
101
Pulmonary tuberculosis, Switzerland.........................................................................................................
99
Stone dust, analysis of, importance of................................................................................................................ 21,22
Stone-dust correlation data................................................................................................................................ 108-112
Stone industry:
Ancient origin of.............................................................................................................................................. 14,15
Effect of, on influenza mortality................................................................................................................... 39-42
Mortality investigations, Aberdeen, Scotland........................................................................................... 15-22
Stoneworkers, agriculturists, and coal miners in Derbyshire County, England, mortality of, from
pulmonary tuberculosis......................................................................................................................................
32
Stoneworkers, mortality, Aberdeen, Scotland.............................................................................................. 149-152
Switzerland:
Lime and brick burners, mortality of, from all causes............................................................................ 97,98
Lime and brick burners, mortality of, from pulmonary tuberculosis..................................................
99
Occupational experience..................................... ........................................................................................... 97-99
Symptoms of fibrosis of lungs, differentiation of..............................................................................................
120

T.
58
Tenement-occupying families, room accommodation, England and Wales..............................................
Tin miners, England and Wales, mortality of:
All causes............................................................................................................................................................
103
Nontuberculous respiratory diseases............................................................................................................
106
Pulmonary tuberculosis..................................................................................................................................
105
Tool grinders and tool carriers, granite-cutting industry, Barre, Vt.:
Average age and years in present occupation............................................................................................
77
Distribution of, by number of previous occupations and years in present occupation.......................
75
Homes of, sanitary conditions as to cleanliness, light, and air.............................................................. 53-56
Tool, instrument, and cutlery makers, England and Wales, mortality of, from pulmonary tubercu­
losis, nontuberculous respiratory diseases, and all causes.............................................................................
38
Tool sharpeners and granite cutters, Barre, V t., and Quincy, Mass., mortality of, from pulmonary
tuberculosis............................................................................................................................................................
32
Tool sharpeners, granite-cutting industry, Barre, V t.:
Average age and years in present occupation............................................................................................
77
Distribution of, by number of previous occupations and years in present occupation.........................
73
Homes of, sanitary conditions as to cleanliness, light, and air.............................................................. 53-56
Trade life and occupational changes................................................................................................................... 69-81
Trade life, effect of, on mortality......................................................................................................................... 42-45
Trades with exposure to mineral dust, incidence of pulmonary tuberculosis....................................... 140-143
Transvaal gold miners, years of employment in present occupation, distribution by................................. 80,81
Tuberculosis and silicosis, signs of.................................................................................................................... 129,130
Tuberculosis, cases of, following employment in dusty occupations...........................................................
135
Tuberculosis history in family and home hygienic conditions, manufacturers and employees, granitecutting industry ol Barre, V t...................................................................................................................... 52,53,55
Tuberculosis of lungs, mortality from, of glass-bottle blowers, sandstone and limestone cutters, and
granite cutters.......................................................................................................................................................
94
Tuberculosis, unrealized promises of prevention of, New York.................................................................... 9,10
Tuberculous and nontuberculous lung diseases, granite cutters of Barre, V t ..........................................36,37

U.
United States and Canada, granite cutters, mortality of:
All causes............................................................................................................................................................25,26
Nontuberculous respiratory diseases.............................................................................................................35,36
Pulmonary tuberculosis...................................................................................................................................
30




178

INDEX.

V.
Page.
Vacation time, distribution by, of granite workers, Barre, V t., and limestone workers, Lawrence
County, Ind...........................................................................................................................................................
89
Vermont granite cutters, mortality of, from pulmonary tuberculosis.............................................. 26,27,30,64
Vermont granites, analysis of................................................................................................................................ 22,23
W.
Washington and Caledonia Counties, V t.:
Farmers of, mortality in families of.............................................................................................................. 62,63
Granite cutters of, mortality in families of...................................................................................... 60,61,65-67
Granite manufacturers of, mortality of, from pulmonary tuberculosis................................................
86
Weight and height, average, of granite cutters of Barre, V t., and coal miners......................................... 48,49
Y.
Yale Medical School, investigations of................................................................................................................




AD D IT IO N AL COPIES
OF THIS PUBLICATION MAY BE PROCURED FROM
THE SUPERINTENDENT OF DOCUMENTS
GOVERNMENT PRINTING OFFICE
WASHINGTON, D. C.
AT

20 CENTS PER COPY

V

8,9